An intrauterine device (IUD) is a small, T-shaped device inserted into the uterus, offering highly effective, long-lasting birth control. There are two main types: hormonal IUDs, which release progestin, and copper IUDs, which are non-hormonal. Both types are over 99% effective at preventing pregnancy, with protection ranging from 3 to over 10 years depending on the specific type.
Immediately After Insertion
Following IUD insertion, immediate physical sensations are common. Many individuals report cramping, similar to menstrual cramps, and light bleeding or spotting. Cramping can range from mild discomfort to more intense pain, often described as a pinching sensation during the procedure itself. Some people may also feel lightheaded or dizzy immediately after insertion, so stand up slowly from the examination table.
To manage discomfort, over-the-counter pain relievers like ibuprofen or acetaminophen are often recommended. Applying a heating pad to the lower abdomen can also help alleviate cramping. Healthcare providers advise avoiding inserting anything into the vagina, such as tampons, or engaging in sexual intercourse for a short period, typically 24 to 48 hours, to minimize infection risk. Strenuous exercise should also be avoided for about 24 hours.
Checking the IUD strings is an important step after insertion. These thin plastic threads extend from the IUD through the cervix into the upper vagina. Your healthcare provider will instruct you on how to check for them, usually by inserting a clean finger into the vagina to feel for them near the cervix. This check helps confirm the IUD remains in place, and a follow-up appointment is typically scheduled within 4 to 12 weeks to ensure proper positioning.
Managing Expected Side Effects
After the initial days, individuals may continue to experience various side effects as their body adjusts. Changes in menstrual bleeding patterns are common and differ between hormonal and copper IUDs. Hormonal IUDs often lead to lighter, shorter periods, and periods may become very light or stop entirely over time due to progestin thinning the uterine lining. About 40% of individuals using a Mirena IUD may stop having periods altogether.
Conversely, copper IUDs typically cause heavier and longer periods, along with increased cramping, especially during the first few months. This occurs because copper IUDs do not contain hormones that thin the uterine lining. These side effects often improve within 3 to 6 months as the body adapts. Spotting or irregular bleeding between periods is also common in the first 3 to 6 months for both IUD types.
Cramping may persist intermittently for several weeks or months after insertion. For many, the worst of the cramping subsides within 24 hours, but mild cramping can continue for up to 3 to 6 months. Other less common side effects, particularly with hormonal IUDs, can include headaches, breast tenderness, or mood changes, which usually resolve within a few months. Managing these ongoing symptoms often involves over-the-counter pain relief and heat therapy.
When to Seek Medical Attention
While many post-insertion symptoms are normal, certain signs indicate a potential complication and necessitate medical attention. Severe or worsening pain not relieved by over-the-counter medication should be evaluated by a healthcare provider. Persistent pain, especially if it interferes with daily activities for more than two days, warrants a call to the clinic.
Heavy bleeding is another symptom requiring medical attention. If bleeding is excessive, such as soaking through a pad every hour, or if it is accompanied by a foul smell, it could signal an infection or other issue. Unusual vaginal discharge, foul odor, or fever and chills are also signs of a possible infection, such as pelvic inflammatory disease (PID), which requires prompt treatment. The risk of infection is highest in the first few days to weeks after insertion.
Changes in the IUD strings can also indicate a problem. If you cannot feel the strings, or if they feel significantly longer, shorter, or if you can feel the hard plastic part of the IUD, it may have moved out of place or been expelled. IUD expulsion, where the device partially or completely falls out, is most likely to occur in the first few months after insertion. If any of these signs occur, or if you suspect pregnancy, contact your healthcare provider immediately and use a backup birth control method.
Longer-Term Experience
Beyond the initial adjustment period, the IUD offers significant long-term benefits as a highly effective and convenient form of contraception. It provides continuous pregnancy protection for several years, eliminating the need for daily pills or other frequent actions. The longevity of IUDs varies by type, with hormonal IUDs typically lasting 3 to 8 years and copper IUDs up to 10 years or more.
Menstrual cycles generally stabilize over the long term. With hormonal IUDs, periods often become very light or may cease altogether, which can benefit individuals with heavy or painful periods. For those with copper IUDs, periods may remain heavier and longer than before insertion, though cramping often improves after the first year. Regular string checks, typically once a month, help ensure the IUD remains in its correct position.
When it is time for removal or replacement, a healthcare provider must remove the IUD. The removal process is generally quick, with a healthcare professional gently pulling on the strings. Fertility typically returns quickly after IUD removal, allowing individuals to pursue pregnancy if desired.