What It Means If You're Cramping After IUD Insertion (And What To Do Immediately)
What the docs have to say.
getty Welcome to the IUD owner club: a club that’s full of women who are freed from fears of unplanned pregnancy for years. Not only do they have an efficacy rate of over 99 percent — which makes them the most effective form of birth control out there — but IUDs last for five to 10 years.
Getting an IUD means you don’t have to set an alarm on your phone to remind you to take a pill, fret over making sure you call in a monthly refill, or worry about scheduling an appointment with your doctor for a shot every three months.
Like any form of birth control, though, IUDs do have a few drawbacks. For starters, they can be expensive upfront (though cheaper over the long run), and your body does have the potential to reject them early on (expulsion is rare and affects only .05 percent to 8 percent of women). Also, insertion can be pretty uncomfortable and lead to extended spotting and, yep, some gnarly cramping.
Cramping after an IUD placement is par for the course, so if you’re experiencing them, know you’re not alone. For some more insight into the topic, we reached out to Dr. Kecia Gaither, a double board-certified OB/GYN and the director of perinatal services at NYC’s Health and Hospitals/Lincoln.
1. Know what to expect during the IUD insertion process.
There are several different types of IUDs to choose from, including Mirena, Kyleena, Liletta, and Skyla (all localized hormonal), and then Paragard (copper). Each has their advantages and disadvantages, ranging from non-reliance on hormones to varied sizes to stopping your period completely. Whatever form of IUD you choose, insertion is the same.
“A speculum is placed in the vagina to visualize the cervix. An anesthetic may need to be used and the canal may need to be dilated [depending on the length of the canal],” says Dr. Gaither. “The IUD is placed in a device that allows it to go through the cervical canal, upon which it stays in place in the upper portion of the uterus. A sonogram may need to be performed to ensure that the device is placed correctly within the uterus.”
You can have this done anytime (permitting you aren’t pregnant). Sometimes it’s even helpful to have it done during your period since the cervix will be slightly dilated for a gentler insertion. Dr. Gaither advises that IUDs can also be placed in the uterus at the time of cesarean section after the baby and placenta have been removed.
As for pain, many describe IUD insertion as a more uncomfortable pap smear. You will feel some pinching, cramping, and general discomfort that lasts for the duration of the insertion, which is about five minutes.
That said, every person’s experience varies, and some women do report greater pain. Dr. Gaither says that it’s common for medical providers to advise their patients to take a medication like Motrin or Alleve, prior to the visit, to decrease discomfort and pain.
2. Cramps can last for various amounts of time.
IUD-related cramping is very similar to menstrual cramping. It is typically a dull and throbbing sensation in the uterus that comes and goes. You may also experience sharp, brief pains. As for how long IUD cramps typically last, there’s no clear-cut answer.
“The length of time someone experiences cramping — or the severity of the cramping — depends on the woman,” warns Dr. Gather. “For some, the cramping resolves in a short period of time. For others, they will always experience some degree of uterine cramping.”
On average, though, you can expect moderate to severe cramping the first two to three weeks following your insertion. The IUD cramping generally decreases over the next three to six months as your body gets used to the device. For many, the cramping usually dissipates completely by six months, with cramping flare-ups around their period (with Paragard) that may be more severe than what they were before their period.
In some rare cases, though, cramping may remain highly uncomfortable even after the first few weeks following insertion. Dr. Gaither says that in these cases, women sometimes wish to have the device removed.
If you’re experiencing severe pain that won’t subsist, you don’t have to be a hero. It’s possible that another form of birth control could be a better fit for your body and your needs.
3. Be aware of the other common side effects of IUDs.
Dr. Gaither says there are a handful of short- and long-term side effects from IUDs. In addition to cramping after insertion, women also experience ongoing spotting that can last for up to six months, nausea, vomiting, breast tenderness, pelvic pain, headaches, and in rare cases migration or expulsion.
The most common long-term effects are a change in menstrual cycle and periods. You may find that your period is longer or shorter, more or less intense, irregular, or more regular.
Ovarian cysts, which are benign but can be painful, are also a side effect, as is pelvic inflammatory disease. Perforation happens in some cases, which is when the device punctures a hole in the uterus. This is very painful and should be addressed immediately.
Bottom line: We’re lucky to live in a world where we have more control over our reproduction, but with this power comes some less-than-desirable side effects. Making the decision to get an IUD is a personal choice and one that you should research well and speak to your doctor about.
Wendy Rose Gould is a freelance lifestyle reporter based in Phoenix, Arizona. She contributes to NBC, Refinery29, Brides, Allure, Spotlyte, Total Beauty, Soko Glam, and others.