IUD Insertion Explained

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We recently received the following concerned question from a patient: "I saw a TikTok video about how painful IUD insertion is and now I am scared to get one. Do they always hurt when they are placed?

We thought we'd take the opportunity to address this highly prevalent social media concern, as many of our patients have been frightened by recent TikTok posts describing extreme pain with IUD insertion. We've found explaining the process in detail can help quelm fear—patients who know exactly what to expect to feel more comfortable. 

In our professional experience, the vast majority of patients tolerate IUD insertion with only minimal cramping. If you're concerned, there are steps you can take before the appointment to mitigate pain. And while we can't speak for others, the nurse practitioners at FPA utilize specific techniques to ensure it's less uncomfortable.  

Before IUD Insertion

Taking Ibuprofen approximately 30 minutes before an IUD insertion is the most evidence-based method to alleviate discomfort during IUD insertion. Our clinicians explain the whole process slowly and thoroughly so every patient knows exactly what to expect.  We give each patient ample opportunity to ask any questions they may have.  

The IUD Insertion Process

The process starts with a slow and mindful pelvic exam to determine the size and position of the uterus. Then, our clinicians have been taught to ASK if it is ok to insert the speculum. This request is crucial to a "trauma-informed" approach because, unfortunately, some of our patients have experienced sexual assault. By asking permission, we transfer the control of the experience to the patient and allow them to dictate their own comfort level.   

Once the speculum is inserted, the cervix is visualized and gently cleansed with a soap called betadine.  The top edge of the cervix is then grasped with an "atraumatic" instrument that does not pierce the tissue (imagine a flat tweezer).

Next, a small instrument (the diameter of a pen tip) is passed through the cervix to measure the inside of the uterus.  Usually, patients feel a sharp cramp for about 5 seconds.  

Lastly, the IUD insertion device is placed through the cervix and the IUD is deployed. Expect a second sharp cramp for 5-10 seconds.

The whole process usually takes less than two minutes. Sometimes, patients can have intermittent cramping similar to menses after the insertion for a couple of hours. Sometimes, patients feel absolutely normal immediately after the insertion. 

Every patient is different and unfortunately, women who experience severe pain with IUD insertion were likely not given the opportunity to participate in the process.  At FPA Women's Health, we make it as our primary goal to ensure that every woman is as comfortable as possible while simultaneously actively participating in their choice to use safe and effective birth control. 

Have questions or interested in an IUD placement? Book an appointment at FPA.