So you’ve finally decided to get an IUD. Firstly, congrats! Think about throwing yourself an IUD-themed party, similar to the first moon party seen here. I know a place that’ll make a uterus-shaped cake. Give these as party favors. All jokes aside, IUDs are a great decision. Why? Because they’re long-acting, reversible, and highly effective at preventing pregnancy. But what can you expect before, during, and after? Welcome to the world of the unknown.

When you’ve decided to get an IUD, you’ll schedule an appointment for insertion with your provider. While you do not need any heavy pain medication for insertion, it is a great idea to take 800mg of ibuprofen about an hour before insertion (as long as you do not have any conditions that prevent you from taking NSAIDs). Stock up at home on whatever it is you generally use, or take, to ease menstrual cramps. Here are some additional tips to prepare for the insertion:

  1. No unprotected intercourse 2 weeks prior to insertion. Why? Well, we don’t want to insert anything into the uterus if there’s a chance you could be pregnant, and a pregnancy test only ensures us up to two weeks prior to the appointment day. Either abstain from intercourse, use condoms, or continue using your previous method.
  2. Being on your period during insertion actually aids insertion if you haven’t yet had a child. It may seem uncomfortable to see your gyno while you’re on your period, but believe me—it doesn’t bother us!

Now you’re totally prepared to arrive at your appointment, right? So what can you expect? IUD insertions start off much like a pap does. Your provider can talk you through the insertion (or not, your choice) so that you know what’s going on. There are two parts to the insertion that cause cramping. The first cramp comes with the measuring of the uterus, the second with the insertion of the device. While these cramps can be intense, especially if you’ve never had a child, they don’t last long. Continue to breathe throughout!! Practice your best zen.

Device is in. Hard part is over! Now you get 3-12 years of awesome, worry-free birth control. But what can you expect going forward? Here are some IUD pearls and other concerns you might have:

  1. What side effects will I experience and for how long?
    • Depending on what IUD you choose, symptoms vary. Irregular bleeding is almost a certainty with any new birth control for the first 3-6 months. With the Paragard (non-hormonal) your periods likely will become longer, heavier, and crampier. With a hormonal IUD, you will experience irregular bleeding for 3-6 months until your body forms a pattern (either a regular period, no period at all, or irregular spotting).
    • Cramping will persist for a day or two post insertion—this is normal! Continue to take an NSAID, use a heating pad, or do whatever it is you normally do to ease menstrual cramps.
  2. Will my partner be able to feel my IUD strings?
    • Maybe. Typically, partners can’t feel them or don’t notice. If they do, don’t panic! The strings soften over time, and you can always make a follow-up appointment with your provider to address this issue—we’ve got tricks up our sleeve to get those strings out of the way. Or you can just tell your partner congrats, you’ve found my cervix.
  3. What if I want to get pregnant?
    • Return to fertility is immediate following removal of the IUD. Set an appointment up for an IUD removal with your provider and get to the baby makin’ after that. Removal of an IUD is (typically) very quick, easy, and much more comfortable than insertion.
  4. What are worrisome signs I should look out for?
    • Heavy bleeding: fully saturating two large, overnight maxi pads in one hour for more than two consecutive hours
    • Cramping worse than insertion
    • Foul smelling discharge
    • If any of these occur, call your provider and let them know. They will be able to decide if you need to pay them a visit or not.

If you’re interested in getting an IUD, schedule an appointment with your provider to discuss your options and preferences. They will be able to guide you to the device(s) that’s best for you.