- IUD insertion can be painful for many reasons – everyone has a different pain tolerance and certain health conditions can also make the experience more painful as well.
- But as women’s health expert Dr. Sherry told INSIDER, a second IUD insertion is often easier than the first because your uterus has had the chance to get used to the first one being there.
- During any IUD insertion, Dr. Sherry said that faulty IUD placement is the most common reason for extreme pain and discomfort during and after the procedure.
- To minimise pain during any IUD insertion, scheduling the appointment while you are on your period can help because your cervix is more open and insertion should be easier.
Before you undergo any major, life-changing medication change or medical procedure, it’s understandable that you might want to do a ton of research. Getting an IUD inserted is a little bit of both, so you can bet I asked a lot of questions and did even more research before making the choice to undergo the procedure. But even with all of my research, there were a few things I wish I’d known before getting an IUD inserted for the second time.
To my very pleasant surprise, my second IUD insertion experience was nowhere near as terrible as the first one had been. I wish I knew that before going in because it would have saved me from stressing so much.
I spoke to Dr. Sherry A. Ross, women’s health expert and author of the book “she-ology. The Definitive Guide to Women’s Intimate Health. Period.” to find out if my second, much better experience is typical – and if some of us may have been unnecessarily freaking ourselves out because we just didn’t know.
My first IUD felt like an umbrella opening in my uterus – and I wish I was exaggerating, but I’m not
Since I first started menstruating, I had debilitatingly painful, heavy, and irregular periods. I distinctly remember one time in high school when I almost fainted because it was so bad. Some friends had to physically drag me into a coffee shop, push me down into a chair, pull out my wallet, and buy me a hot drink they made me carefully sip until I didn’t look like I was going to pass out.
The culprit was, of course, my period – and I couldn’t wait to see my doctor about getting on birth control in the hopes of making my cycle more manageable. For years, birth control pills did exactly that for me – and it was fear of that pain coming back that made me take that pill like absolute clockwork daily.
Sometime later, I began looking into other birth control methods like IUD. I’d heard that one of the side benefits of the IUD – besides being more than 99% effective at birth control, according to Planned Parenthood – is a significant reduction in heavy periods over time.
I told my OB-GYN that I was interested in an IUD. But since I hadn’t given birth to any children, she suggested a smaller IUD option than I had been interested in.
That first time, I went with my OB-GYN’s advice – but it turned out that choosing a smaller IUD didn’t seem to make a difference in terms of how much pain I felt. The pain after the IUD’s insertion was so intense that I almost blacked out. My doctor and her assistant brought me some water and ice chips and they even offered to get me a snack. I laid quietly on the table in severe pain, staring at the ceiling and wondering if I’d just made a colossal mistake.
A few minutes later, my doctor did an ultrasound to make sure it was positioned correctly – and it was. After I felt ok enough to leave, I drove myself home and basically kept my heating pad on at all times for the next completely miserable week.
Some pain during and after insertion is completely normal – and everyone’s pain tolerances and experiences may be different
In a perfect world, everyone’s IUD insertion would go smoothly and we’d all just have perfect birth control experiences and get pregnant only when and if we wanted to and just generally go about our lives. Unfortunately, this isn’t that perfect world – and a number of factors can contribute to the pain you might experience during and after IUD insertion.
“When an IUD is inserted, everyone seems to have a different response depending on your pain tolerance and IUD preparation. It’s completely normal for women to experience moderate period cramps for the first 24 hours if the IUD was inserted correctly,” Dr. Sherry told INSIDER. “When the IUD is not placed into the uterus correctly, period cramps can be more intense and often intolerable.”
She said the placement of an IUD is typically checked using an ultrasound.
“If the IUD is placed correctly inside the uterus and the pain is still horrible, it could also be due to an increased sensitivity to pain. Some women have what’s called a ‘vasovagal’ response to pain. Sweating, feeling hot or faint are common symptoms for those women more sensitive to a painful sensation,” she added. And some women can experience these pains even if the IUD is properly inserted.
All of this assumes that you’re reasonably healthy and well during IUD insertion. If that’s not the case, additional problems can arise.
According to Dr. Sherry, your pain could be worsened if you have a sexually transmitted disease, pelvic inflammatory disease (PID), or conditions like irritable bowel syndrome (IBS), constipation/diarrhoea, endometriosis, pregnancy, interstitial cystitis, urinary tract infection (UTI). She added that if you’re ovulating or have had a history of sexual abuse, you may also feel more uncomfortable during IUD insertion.
There are some steps you can take to lessen the likelihood of IUD insertion pain – and they’re pretty simple
Dr. Sherry gave INSIDER some top tips that can hopefully lessen the discomfort you might experience during IUD insertion.
“Ideally, you want to have an IUD inserted during your period since the cervical opening is slightly more dilated (open) making insertion easier,” she said. “Taking 600-800mg of ibuprofen 30 minutes before the IUD is inserted makes the procedure less uncomfortable. The first 24 hours after insertion is the most painful but taking ibuprofen helps ease the discomfort.”
I don’t recall whether my doctor suggested these steps to me before my first IUD insertion, but I know she told me to do both those things prior to the second one – which may have contributed to why the process went so surprisingly smoothly.
If your first IUD is about to expire and you’re considering getting a second one, don’t let a painful first experience give you second thoughts
If you’re like me, you’ve read plenty of horror stories from people for whom IUDs just didn’t work out – they were too painful, or the IUDs expelled themselves, or other complications arose that resulted in their swearing off IUDs for life. Those stories are terrible and I feel nothing but sympathy for the pain felt by those who have shared their experiences with the rest of us. But if you’re also like me, and your first experience was initially painful but turned out totally fine after a bumpy first few weeks – you might consider moving on to a second IUD with some trepidation.
But Dr. Sherry said it’s not uncommon for your second IUD insertion to be less uncomfortable than your first.
“In my experience, when one IUD is replaced by another IUD there is less discomfort since the uterus is used to having something inside. The uterus is a very smart female organ with a great memory,” Dr. Sherry told INSIDER. “If a previous contraceptive foreign body has been inside the uterus, it won’t be completely blindsided by another IUD replacing it.”
That’s a slightly more detailed explanation than my own OB-GYN gave me when I was completely shocked at how comparatively easy my second IUD insertion was. After the initial intense pinch, I was completely fine almost immediately – the total opposite of how I reacted to the first one.
I was even more surprised by this because I did go with an option that was bigger than my first IUD. Its comparative size difference was one of the main reasons my doctor tried to dissuade me from choosing it in the first place. But size might not always be a huge factor when it comes to tolerance and insertion pains.
“The Skyla is the smallest IUD on the market [in the US] and may be easier for the uterus to tolerate upon insertion. All the other IUDs on the market are similar in size,” said Dr. Sherry. “If you have a normal cavity, meaning there are no fibroids, polyps or anatomical abnormalities, the uterus should be able to tolerate all sizes of the various IUDs. If you have had a bad experience with the regular sizes of IUDs available on the market, trying a Skyla IUD may be a good alternative.”
Finally, your doctor may schedule your new IUD insertion to take place right after you get the old one removed – but it’s seriously nothing to stress about
I I was surprised when my doctor scheduled it this way. It’s a non-surgical procedure, but wouldn’t my body need time to recover? It turns out that isn’t the case.
“It should be very straightforward to have one IUD removed and another one inserted during the same pelvic exam,” said Dr. Sherry. “Faulty placement inside the uterus would be the main reason a reinsertion of an IUD would create unusual and unexpected painful cramping.”
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