Patient education: IUD insertion (The Basics)

What is an intrauterine device? — An intrauterine device ("IUD") is a type of birth control. It is a small, T-shaped device that goes in your uterus. A doctor or nurse inserts an IUD through your vagina and cervix (figure 1).

There are 2 categories of IUDs available in the US (figure 2):

●Copper IUD – This contains copper.

●Hormonal IUDs – These contain a hormone called "levonorgestrel."

An IUD is one of the safest, most effective methods for preventing pregnancy. It can also be used to prevent pregnancy if it is put in within 5 days after unprotected sex. This is known as "emergency contraception."

Some people also use IUDs for reasons other than birth control. For example, 1 type of IUD can be used to treat heavy, painful periods.

How do I prepare for IUD insertion? — You can get an IUD at any time in your menstrual cycle, even during your period.

Before the procedure, your doctor or nurse will talk to you about the IUD you want to get. They can answer any questions you have. They will also:

●Ask about your "health history" – This involves asking you questions about any health problems you have or had in the past, past surgeries, and any medicines you take. People who have abnormal vaginal bleeding, a recent pelvic infection, or some types of cancer generally should not get an IUD.

●Have you sign a consent form

●Make sure that you are not pregnant – If there is any chance that you could be pregnant, they will do a pregnancy test to make sure.

●Offer you testing for sexually transmitted infections ("STIs") – You should not get an IUD if you recently had a pelvic infection. STIs such as chlamydia and gonorrhea can cause pelvic infections. If you do have an STI, your doctor or nurse can recommend treatment.

●Talk to you about what to expect – IUD insertion only takes a few minutes, but it can cause some pain or discomfort. People who have never given birth might feel more discomfort than people who have. If you are worried about pain, your doctor or nurse might give you the option of taking medicine before the procedure. You might want to ask about other ways to reduce discomfort. For example, some people find it helps to do breathing exercises or listen to music during the insertion.

What happens during insertion? — When it is time for the procedure:

●You will lie on an exam table with your knees bent.

●The doctor will do a pelvic exam. This involves checking your vagina, cervix, and uterus.

●The doctor will use a special tool to hold the walls of your vagina open. They will clean the cervix to prevent infection.

●The doctor will insert a device to hold your cervix. They will use a different tool to measure the size of your uterus. This is to make sure that the IUD will fit.

●The doctor will insert a tube that contains the folded IUD. When the IUD reaches the uterus, it is released. Then, the doctor will remove the tube and other tools, leaving the IUD in place.

●When the IUD is in, it will have strings that hang out of the cervix. The doctor will cut the strings to be around 1 inch (2.5 cm) long.

●IUD insertion only takes a few minutes.

What happens after insertion? — After the procedure:

●You can go home right away. You can return to your normal activities as soon as you feel ready.

●You might notice a small amount of "spotting" or light bleeding. This can last for several days.

●You might feel some discomfort and slight cramping. This usually goes away within a day or 2. Over-the-counter pain medicines like ibuprofen (sample brand names: Advil, Motrin) or naproxen (sample brand name: Aleve) can help.

What are the risks of IUD insertion? — Your doctor will talk to you about all of the possible risks and answer your questions. While most IUD insertions are quick and easy, possible risks include:

●Bleeding

●Perforation, which means injury to the uterus

●Infection

●Dizziness or passing out

What else do I need to know? — After getting an IUD:

●Depending on which IUD you have, you might need to use another type of birth control for 1 week after insertion. Ask your doctor or nurse if you're not sure about this.

●Your doctor or nurse will tell you if you should come back for a follow-up visit.

●Some doctors recommend checking your IUD strings once in a while, but this is not usually needed. You might be able to feel them by putting a finger in your vagina. Sometimes, they are hard to feel because they curve up around the cervix.

When should I call the doctor? — Call for advice right away if you:

●Get a fever higher than 100.5°F (38°C)

●Have severe pain in your lower belly

●Feel dizzy or pass out

●Have vaginal bleeding that is heavier than a normal period

●Have bad-smelling discharge from your vagina

●Think that your IUD has moved or come out

●Cannot feel your IUD strings anymore

●Think that you could be pregnant

More on this topic

Patient education: Intrauterine devices (IUDs) (The Basics)
Patient education: IUD removal (The Basics)
Patient education: Long-acting methods of birth control (The Basics)
Patient education: Hormonal birth control (The Basics)
Patient education: Emergency contraception (The Basics)
Patient education: Choosing birth control (The Basics)

Patient education: Long-acting methods of birth control (Beyond the Basics)
Patient education: Emergency contraception (Beyond the Basics)
Patient education: Birth control; which method is right for me? (Beyond the Basics)
Patient education: Heavy or prolonged menstrual bleeding (menorrhagia) (Beyond the Basics)
Patient education: Ectopic (tubal) pregnancy (Beyond the Basics)