Intra-uterine devices, or IUDs, are a very popular method of birth control. Planned Parenthood explains that an IUD is 99.9% effective in preventing pregnancy, whether you choose the copper variety — which makes the uterus inhospitable to sperm — or the hormonal version, which works in a similar way to the progesterone-only contraceptive pill. However, one issue can deter people from getting an IUD: the idea that IUD insertion is painful. People who have one say, though, that the amount an IUD actually hurts depends on the person, but there are ways to be prepared in advance.
Shazia Malik, consultant obstetrician and gynecologist at Portland Hospital in London, tells Bustle that several factors influence the possible pain of an IUD insertion, including "whether the woman has been pregnant and/or had a vaginal birth before, timing in the menstrual cycle, previous cervical surgery and/or cervical stenosis (making the cervical canal unusually narrow or tight), and the experience of the practitioner inserting the IUD." She says that talking to your gynecologist before the procedure, known as "pre-insertion counseling", is crucial, as general anxiety about the procedure can increase pain, too.
The process of having an IUD inserted has several stages. Before the IUD is actually placed, your gynecologist will first do a pelvic exam while holding your vagina open with a speculum, clean your cervix, and measure your uterus using a device called a sound. For some people, that step is the part that causes the initial pain. "For me the worst part was the probe that they insert before the IUD to measure the depth and tilt of your uterus," Ayla, 33, tells Bustle. "It became clear (blindingly, searingly, white hot clear) to me in that moment that this was the first time I had felt something, anything inside my uterus. I remember feeling like the pain was more inaccessible and abstract than anything I'd felt before."
Some people have local anesthetic injected into their cervix before the insertion happens, but this is a highly individual choice and depends on whether the option is offered by your gynecologist. Local anesthetic can be a good way to help numb the discomfort of insertion, but its effectiveness can also be mixed.
Emily, 29, received three doses of local anesthetic when having her IUD fitted. "After the first one he prodded the cervix and asked if it was uncomfortable. It was. So he gave me another injection. Also painful," she tells Bustle. After three doses, "I could feel no difference from before having any anesthetic, but in the meantime I'd taken three needles to the cervix."
For other people, however, the process of IUD insertion can be seamless and pain-free. "I was really worried that it was going to be painful," Lea, 32, tells Bustle. "When I was at the nurse's to have the IUD inserted, at one point she said, 'Okay, now you're going to feel it, I'm sorry, it'll be like a pinch.' And I was waiting... until she made it clear it had been done already. I had felt absolutely nothing. The speculum felt more of a discomfort than the IUD itself."
Basically, it's difficult to predict how you're going to feel when you have one inserted. So how can you reduce the pain of IUD insertion? First and foremost, it's worthwhile having a frank discussion with your gynecologist about your pain threshold and your concerns. If you've ever experienced pain during a pap smear or exam, it's important to have that on the table.
"It's really important to be sure it's the right contraceptive for you and to feel confident about the procedure and the person inserting your IUD," Malik tells Bustle. "Make sure you have had a full discussion at your previous visit with your clinician so that all your questions are answered and you feel confident on the day." And do your research, she says: "Speak with friends who have an IUD and are happy with it. Don't read and believe all the horror stories!"
On the day itself, Malik suggests a number of different strategies to reduce the pain. "Try and practice relaxation techniques prior to and during the procedure," she tells Bustle. "It can be helpful to take painkillers (such as ibuprofen) an hour or so before the insertion — not on an empty stomach and only if you have safely taken it before. Ask for local anesthetic gel if you think you might need it." Aftercare is also important, she says. "Allow enough time to get to the appointment and also afterwards to allow you to feel ready to go back to home or work."
IUD pain can vary widely, so it's a good idea to make sure you have a foundation of trust with your medical practitioner and know all your options. Whether it's local anesthetic, ibuprofen, or breathing techniques, there are many choices to help you get through your individual experience of IUD insertion with as little stress as possible.