home
RSS
November 22nd, 2010
10:03 AM ET

Is there a way to ease IUD insertion pain?

Every weekday, a CNNHealth expert doctor answers a viewer question. On Mondays, it's pediatrician Dr. Jennifer Shu.

From Janeer of Georgia

Last month as a birthday gift to myself, I scheduled an IUD. It hurt like the dickens and I didn't get the IUD. I'm 31, I have a steady boyfriend and I don't want to tie my tubes yet. Is there any way I can get an IUD without feeling excruciating pain?

Expert answer

Thanks for your question. To best help you, I consulted with Dr. Jennifer Gunter, an OB-gyn at Kaiser Permanente in San Francisco, California, and author of "The Preemie Primer: A Complete Guide for Parents of Premature Babies–from Birth through the Toddler Years and Beyond." She shared the following information:

An IUD is an excellent form of contraception. If you would like to try this method again, here are some ways to make the insertion a little less painful.

The pain of insertion is usually either from trying to pass the IUD through the cervix or from the uterus cramping in reaction to having the IUD in place.

To help reduce pain, it is helpful to schedule the IUD insertion during your period. At this time of the month the cervix is open just a little bit and can make all the difference in the world.

I recommend using a cervical block, meaning injecting anesthetics (numbing medication) in the cervix. That should take away any pain from stretching the cervix to insert the IUD. If the cervix is very tight (the doctor will know from the first insertion attempt) sometimes placing a medication called misoprostol in the vagina a few hours before the procedure can soften the cervix and make it easier to insert the IUD.

Finally, it can help to take ibuprofen at least 30 minutes before the procedure. This will reduce pain as well as any cramping that might occur afterwards. Since you had a lot of pain you might want to talk with your doctor about taking prescription-strength ibuprofen before the procedure."

Good luck!


soundoff (47 Responses)
  1. Molly Maverick

    All of those people who are like "there's no nerves up there... you won't feel anything" are utter idiots!
    Kick them where they don't have any nerves...

    November 22, 2010 at 10:54 | Report abuse | Reply
    • Alex

      Haha, no kidding! The actual insertion for me was okay, but the cramping/bleeding afterwards was horrible!! Oh the joys of being a woman!

      November 22, 2010 at 12:10 | Report abuse |
    • Linda B.

      I agree. Minimal discomfort with the insertion but more problems afterwards, including the inability to conceive after it's removal 9 months later. Would never recommend an IUD.

      November 22, 2010 at 22:02 | Report abuse |
    • Kris

      Hope it goes better next time. I had a copper 7 inserted when I was 22. Insertion was not bad; cramping after lasted an evening, and was not as bad as cramps during period. Had it removed 6 years later and was pregnant within 2 months. Waited 3 months after first child to have a new IUD; this time only had it for a year as we wanted a second child. I was pregnant within days of having it removed the 2nd time. Used an IUD again until I was 35 and we decided no more children.

      When I was on the pill for 2 years before getting an IUD, I had problems when I quit taking it and didn't have periods until I had hormone therapy. I also discovered that the extreme mood swings I was having were apparently caused by the pill as they went away as soon as I changed my birth control method.

      I found the IUD to be effortless and, otther than the mild cramping the first time I had one inserted, pain free. It was a great way to manage our family planning. Good luck.

      November 22, 2010 at 22:48 | Report abuse |
  2. Andrea

    I didn't have a problem either with the insertion or cramping...but I've also given birth, which makes it much easier. It's the best form of birth control I've ever had (four day VERY LIGHT cycles, no cramping or PMS, don't have to think about it for five years) and I highly recommend it if you can bear the insertion.

    November 22, 2010 at 12:14 | Report abuse | Reply
    • Alex

      I've also given birth and I still had the cramping so I'm a bit jealous. As for the best form of BC, I am up in the air! I can't do hormones so the copper IUD is really the only option for me besides condoms or a diaphragm, but I have gotten pregnant twice and miscarried both times with the IUD (and I have had ultrasounds confirming it is still in the right place). I am looking into alternate BC, but for now, I feel kind of stuck!

      November 22, 2010 at 13:42 | Report abuse |
  3. Anne, NP

    I've inserted hundreds of IUD's and 800 mg of ibuprophen 1 hour prior to insertion and if a paracervical block is not available, have the clinician use some lidocaine gel in the endocervical canal.

    November 22, 2010 at 12:32 | Report abuse | Reply
  4. guest

    I am on my 2nd 5-year IUD (I have 2 children). I have had no period for over 6 years. The removal removal/insertion of the 2nd was pretty painfull, but well worth it!

    November 22, 2010 at 12:43 | Report abuse | Reply
  5. Desiree

    When I had my IUD inserted, it was relatively painless (I haven't given birth) - and 6 months after, my periods are pretty light! I even have the paraguard... love it!

    November 22, 2010 at 13:44 | Report abuse | Reply
    • pn

      Me too – I have had a wonderful experience with the copper iud...

      November 22, 2010 at 15:50 | Report abuse |
    • RC

      I also have the Paraguard, have never given birth either. Haven't had any problems, and it's been a year. My periods are normal as if I don't have an IUD, but the cramping is a little more intense. Nothing ibuprofen doesn't fix! Speaking of which, the NP told me to take 3 (600mg) and up to 4 ibuprofens before the procedure and it was relatively painless, just mildly uncomfortable, especially while measuring the sound. It was all over in 15 minutes though!

      November 22, 2010 at 22:46 | Report abuse |
  6. jlb

    Sounds like she never had kids. It is less painful if you already had a baby since it is all been stretched out. I had my first daughter by c-section and my IUD insertion was not too uncomfortable. I took some Advil beforehand. I just had my second daughter and getting my second IUD on Wednesday. I have the Paraguard which causes a heavy period but it beats taking a pill every day and putting hormones in my body.

    November 22, 2010 at 14:56 | Report abuse | Reply
  7. Stephanie

    I also got paraguard because I cannot take hormonal birth control anymore either. I have not had children or ever been pregnant and it was very painful when I got it inserted and I had days of cramps and bleeding afterwords. My periods are not regular yet, the first couple cycles were close together and I bleed heavily. I guess it is better than other alternatives, but I have only had it since August so I will just have to give it time.

    November 22, 2010 at 15:04 | Report abuse | Reply
  8. anon

    I am on my third Mirena. The first was semi painful, but not too terrible. Removal a piece a cake. The second one (different doctor) was horrifically painful (both 1 & 2 prior to ever being pregnant). The removal was a piece of cake again. The third was painful to be inserted as well, but I was 7 weeks post partum. The midwife had a hard time getting it in the right place, but once in it was fine.

    November 22, 2010 at 15:19 | Report abuse | Reply
  9. ANON

    I second the cerv block – I'm on my second Mirena, no babies. First time was very painful, but I was over it in two days. Second time I had a different doc and he uses cerv blocks on all IUD insertions. It was a breeze and my weekend was wonderful.

    November 22, 2010 at 15:28 | Report abuse | Reply
  10. np

    I got the paragard (copper IUD) because I could not handle horomones (plus 10 year protection!). While the insertion was painful the payoff has been exceptional. Give it time, gals. Your periods should become normal again and the additional cramping will ease off in a few months.

    November 22, 2010 at 15:48 | Report abuse | Reply
  11. LB

    I had to have mine taken out 6 weeks after insertion. I would highly recommend people really researching these before getting them done. I spent 6 weeks in excruciating pain. I now have the urge to pee frequently and it's only been since the IUD. It was the worst decision I've ever made in my life. I have friends who have had no problems.....to date. But, I feel it has done irreversible damage.

    November 22, 2010 at 16:31 | Report abuse | Reply
  12. Kelly

    Hurt like hell!! Then it came out 4 weeks later.

    November 22, 2010 at 16:52 | Report abuse | Reply
  13. puggerspaniel

    I got this done and the first time was exactly how you described it. But they prescribed me this medication (forgot what it was called?) that you take the night/day before that opens up your cervix. When I went in the second time, it was inserted so fast and painless. It was so quick and simple, why they didn't give that to me first is odd. They should give this to everyone (unless you just given birth)

    November 22, 2010 at 17:39 | Report abuse | Reply
  14. Cindy

    I got Mirena 2 months after giving birth. It was completely painless. I didn't even feel the numbing shot. No cramping afterward either. I haven't had a period in 11 months! I am very happy with Mirena.

    November 22, 2010 at 18:55 | Report abuse | Reply
  15. Sadie

    I had a terrible experience with an IUD. The insertion was very painful, and it was definitely not worth it. I had it taken out after two weeks because it felt like it was poking me. I haven't had kids, FYI. I just got Implanon about a month ago and am much happier with it- I would recommend it over an IUD any day. Also, my mother had an IUD and rejected it- her body tried to push it out.

    November 22, 2010 at 19:20 | Report abuse | Reply
    • Lauren

      Be careful with the Implanon- I had to have mine taken out. The first few months were AMAZING- light periods, no mood swings, no cramps. Then in September the three week long heavy periods hit. I'd be on for three weeks, off for two or three days, then bleeding again. It was causing too many problems and according to my gyno it is because for some women, the body can adapt to the hormone and try to compensate, which mine did.

      November 29, 2010 at 16:45 | Report abuse |
  16. GSP78

    I was tired of hormonal birth control, so I tried the copper IUD. I remember it feeling like a very strong menstrual cramp, but only lasted 30 seconds. I had cramping afterward, but only for a day, and it wasn't any worse than a really bad cramp. Unfortunately for me, my uterus is smaller than normal. After only 2 weeks I had to have it removed, because it was partially expelled from my uterus. My husband could also feel the strings, which was painful for him. The doctor saidthat my uterus is too tiny, and the only thing that can stretch it out was having kids. Back to hormones!

    November 22, 2010 at 19:36 | Report abuse | Reply
  17. chickyd

    It hurt for the two seconds it went in. I didn't bleed afterward, no cramping. It was awesome. I got mine without having kids first so my cervix wasn't post-kid size and the doc told me to inhale as it went through. That helped. Best thing that I got done (so far). I didn't have any numbing shots or pain pills, nor any pain afterwards. I'd recommend it anyday, lol, in fact 2 of my friends now have it;)

    November 22, 2010 at 20:37 | Report abuse | Reply
  18. Christina

    I got an IUD, and I was in terrible pain for three weeks. I went back to the doctor, and she has perforated my uterus when she inserted it. It had been sitting in my abdominal cavity for weeks, and they had to do emergency surgery to remove it. I would just keep taking the pill if I was someone considering it because it isn't worth it.

    November 22, 2010 at 20:52 | Report abuse | Reply
  19. brittany

    i got the mirena in 2008 after i had my youngest son, the first time i tried to get it they couldnt open me up enough to put it in, the dr said if she kept trying she would have ruptured my uterus so she waited 2 months then she got it in and it hurt so bad both times, i almost cried. but after i had it in i had my period very lightly for about 3 months and since then i havent had it at all. its a very wonderful BC and would recommend it for every woman that can handle hormones.

    November 22, 2010 at 21:04 | Report abuse | Reply
  20. Manda

    I never had children and got the IUD it was the best choice I ever made.... But I will say having it put in hurt the most and the cramping afterwards hurt. When I went back for a follow up the doctor explained it the best by saying your body is trying to reject it since it's not suppoe to be there... But after a few days I was back to normal and I have never had any problems with mine at all and would recommend it to anyone especially younger people such as myself who don't plan to have children for a while.

    November 22, 2010 at 21:40 | Report abuse | Reply
  21. LMEL

    I tried to get an IUD about 6 months after I had a child and I had excruciating pain as well. It turns out, the IUD perforated my uterus and I had to have surgery to have it removed. The drug companies tell you in the materials that there is a 1/1000 chance of this happening, but they don't mention that there is a higher rate of this happening if you are currently breastfeeding or have previously had children. Make sure you really think this through. The consequences can be far worse than just temporary pain!

    November 22, 2010 at 22:44 | Report abuse | Reply
  22. amanda

    The iud works great for me. Its the only birth control that prevents me from getting pregnant! the pill and patch just didnt do it for me, as i have 3 children and now have the iud for the last 6 years! Love it!

    November 22, 2010 at 23:21 | Report abuse | Reply
    • um...yeah

      you do realize that the IUD does NOT prevent pregnancy, right? you could feasibly be conceiving human life every month. the IUD just prevents the embryo from attaching iself to your uterus, so it dies and comes out with your period. what's wrong with condoms??? I have been married 14 years, can't stand the hormone crap, would never use IUD, and we love condoms. nice and neat. ;) (btw, I am not an anti-abortion freak, I just don't think many women understand exactly how IUD's work.)

      November 23, 2010 at 13:10 | Report abuse |
    • Erin

      In reply to whoever replied to you. The copper IUD DOES prevent pregnancy, actually. It interferes with sperm cell movement by stimulating an inflammatory response in the uterus, causing changes that damage or kill sperm and that may damage the egg as well. If an egg does get fertilized, TRUE, it makes it difficult for the egg to implant, but the primary birth control method PREVENTS pregnancy. Thank you.

      November 24, 2010 at 09:05 | Report abuse |
  23. angela

    i just cringe when i hear the word iud because of everything me and my micro preemie had to go through because of it though i am thankful to have her alive and well i wouldnt recommend the paraguard to anyone. After having 3 kids i wanted to be done but didnt want to tie my tubes at age 24. It worked great for the first 4 years but i ended up pregnant and by the time i got an ultrasound i was 3 1/2 months and the dr. Actually saw it in there with my baby. I had lots of blood tinged discharge through the 25th week when i went into labor for no apparent reason. I knew it was because of the iud. My baby survived and weighed 1 lb. 15 oz but had immature lungs and had to be on many types of ventilators to help her breath which ultimately damaged her lungs. 1 year and 4 months later she finally can be without her oxygen but what a journey it has been. I thank god for her everyday-iud or not she was meant for me.

    November 23, 2010 at 01:04 | Report abuse | Reply
  24. IUD

    I have a high pain tolerance. I had my babies without an epidural but having the IUD inserted hurt like hell. I bleed for a year after wards. With that said, I would do it again. I no longer have heavy periods, only light monthly spotting. No more painful menstrual cramps. I don't have to think about birth control. It's handled.

    November 23, 2010 at 02:31 | Report abuse | Reply
    • Stella

      You bleed for a year, was it heavy and with bad cramping? I'm having a hard time with this and want to know if it just me.

      November 23, 2010 at 14:49 | Report abuse |
    • Name*lupe

      Omg a year? I just got the iud put in 2 weeks ago and i have been bleeding almost since i got it in and im going crazy bleeding. Is that normal to bleed that long?

      November 27, 2010 at 20:41 | Report abuse |
  25. amayda

    I love my mirena. Had it put in after my second kid and only had minimal pain and cramping for the rest of that day. Had light spotting for the next couple of months and now all I have is a day or two of light spotting every six or eight weeks. So much better than the pill. Now that we are not planning on more kids I am going to get the Essure done before the mirena needs changed.

    November 23, 2010 at 08:09 | Report abuse | Reply
  26. Michelle

    So glad I got a hysterectomy. All this bull? No way!

    November 23, 2010 at 09:37 | Report abuse | Reply
  27. Stella

    got mine in last December and still in major pain and major bleeding. I know it takes a while but come on!! I usually take a little longer for my body to get used to medicine and such but I think this isn't for me. Has anyone else had that problem?

    November 23, 2010 at 14:43 | Report abuse | Reply
  28. Jane

    I got my paragard copper IUD three weeks ago. I had no idea it would be painful or uncomfortable because I was misinformed. I would call the insertion... tolerable, but I think since I was expecting something that felt like a pap smear, it was quite unpleasant. I felt a shooting pain run up my side and around to my back followed by intense nausea. I told my doctor I felt as if I needed to vomit (and run to the bathroom) and she said it was a normal response to her touching my cervix.

    I recommend taking ibuprofen- like a large dose... 800mg maybe- before insertion. Ibuprofen will help ease the pain during insertion as well as the cramping afterwards because it prohibits prostaglandin synthesis (the little buggers responsible for muscle contractions). I didn't take anything because I wasn't aware I needed to, but I feel like a large dose or Motrin would have prevented that.

    Currently, I've had some weird spotting (false periods), even weirder discharge, which I read was normal (it looks... copper-colored) and mild cramping at the most random times. A few nights ago, I woke up experiencing contractions every 30 minutes, which I thought was very strange, and I'm going to mention it to my doctor when I go back in two weeks.

    HOWEVER, I don't have crazy mood swings, cravings, bloating like I did on the pill. And I love the idea that it lasts for ten years (I'm 27 w/no kids and one previous pregnancy- I want kids someday) and also I paid zero dollars for it because my insurance covered 90% and my doctor covered the rest. Cheaper than 20/month for LoestrinFE, and that's WITH insurance.

    I would, thus far, recommend the copper IUD. If you can tolerate cramps randomly and frequently, this is about the worst side effect I'd say. I usually have very little cramping and only the day before my period and one or two days after. It's weird to have cramps in between my periods, and when I'm walking around TJ Maxx, at work, etc. It's like, neverending cramps. I don't mind them so much but they're annoying.

    November 24, 2010 at 09:17 | Report abuse | Reply
    • Jane

      Also, I was on my period. I don't know if that eased any potential pain, but I do know that it caused massive bleeding afterwards. Like... the rest of my period came out THAT DAY. So if you go when you're on your period, bring extra underwear an PADS because my doctor told me not to use any tampons for the rest of my period to "make sure it gets situated in there."

      November 24, 2010 at 09:23 | Report abuse |
  29. Tiffany

    The cervix is more sensitive than a doctor may lead you to believe!
    I think that this experience must be different for everyone. I had the Paragard iud inserted a few years ago at age 23 to avoid hormones. I took a Vicodin beforehand knowing that if it says 'mild discomfort' in the pamphlet, it is going to hurt a lot. I actually passed out from the pain of insertion, then when I came to, I vomited. It was quite awful. I stayed in bed for two days afterward because of the severe cramping. Subsequent periods were wretched, intense spasms of pain, heavy clotting, etc. My periods felt more like a miscarriage each time. I left it in for a year and a half before I could convince a physician to give me a tubal ligation.

    Long story short, iuds are a wonderful concept, but don't work for everyone. I say give it a few months. If your periods are consistently bad, it may be time to consider other options. Best of luck to you!

    December 1, 2010 at 01:14 | Report abuse | Reply
  30. Lindsey

    I strongly suggest that if you are considering an iud....that you need to do A LOT of research. My daughter was born May 31st 2010, I did plenty of research(or so I thought) had it put in @ my 6 week check up, the doctor told me I would be fine and went ahead with it. It hurt so bad, that I grabbed the table and thought I was gonna die! I've had 2 kids, so I thought it wouldn't hurt from what I read. I felt like I got hit by a truck....I've had it in for about 6 months and all of a sudden started bleeding and cramping really bad, and I already had my period for the month. I went to the doc, she couldn't find it...ultrasound, still nothing.X-ray, found it! It preferated my uterus and was in my pelvic area up past my uterus!!!!! Ouch!!! I have to habe surgery mon to have it removed. They say this is very rare but it does happen and it sucks! Its been like this since I had it put in....could never feel the strings, just thought she cut them shorter then normal. And I was totally new to this so I just assumed it was fine. Still got my periods...but they were soooooo bad every month! I would call and they always just told me that it takes awhile for your body to get used to it. So, if you are considering this, be prepared, research....if you can't feel the strings, and your period is really heavy, talk to your doc! Not trying to be the negative one on here, I just want to make it known and educate others on this and share my experience. I am so scared for mon (dec 27th 2010) never had surgery, or been put under!)

    December 22, 2010 at 13:59 | Report abuse | Reply
  31. Bev

    My daughter is 5 years old and I faintly remember the pain when I got my first IUD. I just had my old one replaced (today as a matter of fact) and I thought I'd be ok. I felt quit a lot of pain, but everybody is going to have a different reaction.

    May 23, 2011 at 17:33 | Report abuse | Reply
  32. Sheryn

    I am 28 years old, have never been pregnant/never had ant children and just had my IUD inserted this morning. I took 1000mg of Naproxen before I left the house and had my husband accompany me so he could drive back. It was uncomfortable/a bit painful getting sounded for measuring the depth of my uterus, I had the same level of pain for the actual insertion of the IUD. It only took a few minutes for me, but I am also at the very beginning of having my period. It isn't bleeding yet but I did have some very light discharge when I went in which may have helped.

    I have had lower abdominal cramping afterward but I would categorize it as very bad menstrual cramps. I am also experiencing more heavy discharge since the insertion. I slept for a few hours on my back after I got home since walking around wasn't feeling the best. Overall I think the procedure went well and I could tolerate the pain, even without the cervical block or other pain medications since the Dr. didn't feel they were necessary. I also took 500mg of Naproxe after I got up from my nap, so for me I have been able to keep my own pain and discomfort at a manageable level.

    December 17, 2012 at 18:20 | Report abuse | Reply
  33. Sophie

    I had mine inserted without a local anesthetic. Just took some Motrin prior. I have given birth via c section twice, once 12 years ago after 16 hours of excruciating labor and the second time 4 years ago again after some labor.

    With the iud insertion I had one single mini contraction. NOT painful. Somewhat uncomfortable maybe some pressure. But after having c sections wide awake, this doesn't even register as painful.

    May 17, 2013 at 17:19 | Report abuse | Reply
  34. Liz

    I just got my copper IUD (Paragard) inserted this morning (about 6 hours ago). I'm 24 and have never been pregnant, and the idea of having a birth control method that's more than 99% effective with minimal effort is extremely appealing.

    After seeing a lot of horror stories on other forums, I was beyond nervous about the insertion process. The doctor (FNP, CNM) was amazing. She had me take one Xanax (for the anxiety) and 800mg ibuprofen beforehand, and the insertion went quite smoothly. It was not comfortable by any stretch of the imagination, but the pain only came in about two 10-second bursts. I swore a bit during the sounding of my uterus and the actual insertion of the Paragard, but after it was over I just started laughing and thanking the doctor and nurse because I couldn't believe it was over that easily! The whole thing was over in less than ten minutes from the time I undressed to the time I walked out. I've had some bleeding since then (nothing a small panty-liner can't handle) and a very mild crampy feeling (little bit of ibuprofen took care of that).

    Overall, I'm glad I chose the Paragard and can't wait to start reaping the benefits of worry-free, more spontaneous sex with my loving boyfriend. :)

    June 27, 2013 at 18:06 | Report abuse | Reply
  35. Jackie

    Yes. It's called take 4 ibuprofen ( I also took hydrocodone ) and breathe. Use breathing techniques and distract yourself by doing something- count tiles, look at a plant, and know that it's temporary. Everyone will tell you, and it's true, it hurts a lot. It's not like any other pain you'd experience unless you've been through labor. I did get dizzy and almost fainted after. However, other than light cramping for the next couple days, and an onset of my period, i'm fine. The thing to remember is.... you'll be fine and it's temporary. You're not going to die.

    August 21, 2013 at 15:52 | Report abuse | Reply

Post a comment


 

CNN welcomes a lively and courteous discussion as long as you follow the Rules of Conduct set forth in our Terms of Service. Comments are not pre-screened before they post. You agree that anything you post may be used, along with your name and profile picture, in accordance with our Privacy Policy and the license you have granted pursuant to our Terms of Service.

Advertisement
About this blog

Get a behind-the-scenes look at the latest stories from CNN Chief Medical Correspondent, Dr. Sanjay Gupta, Senior Medical Correspondent Elizabeth Cohen and the CNN Medical Unit producers. They'll share news and views on health and medical trends - info that will help you take better care of yourself and the people you love.