An Intrauterine Device (IUD) is a highly effective, long-acting, reversible contraceptive method. This small, flexible, T-shaped device is inserted by a healthcare provider directly into the uterus. Two primary types are available: the hormonal IUD releases progestin, and the non-hormonal IUD uses copper. Both types are designed for long-term use, offering years of continuous protection without requiring daily attention.
The Physical Sensation of Insertion
The IUD insertion procedure itself is typically brief, often lasting around five minutes or less once the provider is ready. Before placement, a speculum is used to visualize the cervix, which may cause a feeling of pressure. The most intense sensations occur during two specific steps: measuring the uterine depth and the device placement.
The process of measuring the uterus, known as “sounding,” involves inserting a thin instrument through the narrow opening of the cervix. This step can trigger a sharp, intense cramping sensation, which is the uterus reacting to the instruments passing through its muscle. When the IUD is finally pushed into place, a similar, strong cramp is often felt as the device’s arms deploy inside the cavity.
These acute, sharp sensations generally subside within seconds or minutes of the device being correctly seated. Some people may also experience temporary reactions like dizziness, sweating, or nausea during or immediately after the procedure. Immediately following the procedure, moderate cramping and a backache similar to a heavy period are common.
This post-procedure discomfort is normal and may persist for a few hours or up to a day or two. Taking an over-the-counter anti-inflammatory medication about an hour beforehand is often recommended to help mitigate the immediate cramping. The pain associated with insertion varies widely, depending on factors like personal pain tolerance and whether they have previously given birth vaginally.
Daily Life: How the IUD Feels While In Place
Once the IUD has settled into the uterine cavity, the vast majority of users do not feel the device itself during their regular daily activities. The IUD rests within the upper part of the uterus, an organ that is not sensitive to the internal presence of the device. If a user feels the hard plastic part of the IUD, it may signal that the device has moved and is partially expelled into the cervix, which requires immediate medical attention.
The only physically accessible part of the IUD is the pair of thin, flexible strings, which extend about one to two inches through the cervix into the upper vagina. These strings are present so a healthcare provider can remove the device later. Users are often taught to check for these strings monthly to confirm the IUD is still in the correct position, where they feel like soft, fine threads curled near the opening of the cervix.
During sexual intercourse, the IUD itself is located well beyond the area of penetration and should not be felt by the user or their partner. While the plastic threads might occasionally be felt by a partner, they are soft and highly unlikely to cause any pain. If the strings are felt and cause discomfort, they can sometimes be trimmed shorter by a provider or will soften and curl up against the cervix over time.
Understanding Physical Adjustment and Side Effects
The body’s reaction to the IUD involves an adjustment period that typically lasts between three to six months as the uterus adapts to the presence of the device. During this initial phase, irregular bleeding, spotting between periods, and cramping are common as the uterine lining adjusts. The long-term physical experience differs significantly depending on whether the IUD is hormonal or non-hormonal.
The copper IUD, which contains no hormones, creates a localized inflammatory reaction that is toxic to sperm. This non-hormonal mechanism often results in heavier and longer menstrual periods, as well as increased menstrual cramping. These symptoms tend to lessen over the first few months but may persist for the duration of use.
Conversely, the hormonal IUD releases progestin, which thins the uterine lining and thickens cervical mucus. This mechanism typically leads to lighter periods and reduced cramping over time, making it a treatment option for heavy or painful periods. For many users of hormonal IUDs, periods become shorter, lighter, or may stop entirely after about six to twelve months of use.
However, the hormonal IUD may initially cause irregular spotting or less predictable bleeding for the first three to six months. Severe or persistent cramping that does not improve after the initial few months may signal that the device has moved or is partially expelled. If cramping is intense, constant, or accompanied by fever, a healthcare provider should be consulted.
What IUD Removal Feels Like
The removal of an IUD is usually a much quicker and less intense experience compared to the insertion process. The procedure involves the provider placing a speculum to visualize the cervix and then gently pulling on the IUD strings with forceps. This action causes the device’s flexible arms to fold upward as it passes through the cervical canal.
This quick removal typically results in a brief, sharp cramp or tugging sensation, which lasts only a few seconds. While some people may feel a similar, short-lived cramping as the device exits, many describe the feeling as merely a momentary, uncomfortable pinch. Any residual cramping usually dissipates quickly, allowing people to resume their normal activities immediately.