Bedsider

No Pain, No Gain: The IUD Insertion Process

Originally published on November 11, 2009 on SexReally.com.

I wish I could say that getting the IUD was easy once I made my decision that the love affair with the Pill was over. In reality, it took me three visits (one of which was an appalling comedy of errors) before I finally baby-proofed my uterus. First, I had to get a pap smear, since STIs in IUD users can cause Pelvic Inflammatory Disorder and in rare cases, infertility. (For that same reason, doctors typically recommend that you only get the IUD if you’re in a long-term, monogamous relationship.) An abnormal pap result delayed my efforts further. After a lab test determined that some cervical lesions were low-grade and no cause for alarm, I finally found myself face-to-face with a foot-long box containing my IUD. Thankfully, the size was misleading.

The IUD is actually just 1.5 inches long. Still, that little device was responsible for the most painful experience of my life and I say this as someone who’s gotten five piercings and a tattoo. Forgoing anesthesia and prescription painkillers, I whimpered with my boyfriend by my side as the doctor fit the IUD into place. I felt intense cramps (similar to contractions, I imagine) the second it entered my body. Utterly shaken by the invasion of this foreign object, my legs trembled and my teeth chattered uncontrollably. I gripped my boyfriend’s hand and whispered, “Remind me to get a C-section if I ever decide to have kids.”

That’s probably as close an approximation of childbirth as I’ve ever experienced, but I don’t have any complaints about the IUD now that the initial ordeal is over. Despite a crampy first week and spotting (which can last for several weeks), I’ve been pretty pleased with the IUD, which has rendered the pesky birth control pill unnecessary. Total cost for five years of a worry-free womb? $0. My insurance policy — and many others — covers the device and the insertion procedure entirely. Compare that to $480 for five years of my generic pill.

Unlike me, you should take some advance measures to prepare yourself for the insertion. Becoming pregnant, even if you don’t carry the pregnancy to term, makes it easier to insert the IUD in your cervix, which is why some doctors won’t do insertions for never-before-pregnant women. One of my friends, who got the IUD a month after she gave birth to her first child, claimed that it even hurt more than labor. Conversely, I heard from many other women that insertion was no more uncomfortable than a pap smear. In my opinion, better safe than sorry either way. Unless you’re certain you can withstand a lot of pain, going the all-natural route might lead to a rude cervical awakening. Here are a few things that you can do to avoid my experience:

• Say yes to drugs. Getting a prescription for something that dilates your cervix will do wonders to minimize pain and make insertion easier. My friend, who I accompanied to an IUD appointment a week after my own, only needed 30 relatively-bearable seconds for the procedure, which lasted four excruciating minutes for me.
• Welcome Aunt Flo. Schedule your appointment to coincide with your menstrual cycle since your cervix will already be slightly dilated then. Don’t worry about what your gynecologist will think about the mess. They’re used to it and many will probably recommend waiting until your period anyway.
• Midol will be your best friend. I’m so wary of over-the-counter medication abuse that I don’t even take ibuprofen for headaches, but in the days following my IUD, painkillers were the only effective weapon against severe cramping that would have otherwise left me incapacitated. After your appointment, keep handy Midol and any painkillers that target lower abdominal pain and menstrual symptoms.
• Rough sex is out of the question. (At least for the first week.) Your cervix won’t appreciate head-on collisions for a while. Though I only needed a couple weeks to recover, one of my friends said penetrative intercourse was uncomfortable for the first month. If you can’t wait, either try to take it easy or be prepared to feel crampy in the afterglow.
• Heat up. Self-heating stick-on pads (the kind you can get at drugstores for sports injuries or menstrual pain) help alleviate discomfort throughout the day. At home, a hot water bottle or an electric blanket will also do the trick.

There are other birth control methods, many of which don’t require an uncomfortable insertion process, but for many women the IUD causes relatively few side effects compared to options like the Patch. Even the Mirena, which releases progesterone, is relatively low-hormone compared to other forms of hormonal contraception. If you think you can brave the gynecologist’s table, look into the IUD. It’s affordable, widely available, and foolproof.

*Editor’s note: Dr. Maria Rodriguez wrote an article for Bedsider, “5 myths about IUDs, busted,” addressing some of the challenges Lena came up against when she got her IUD. We highly recommend checking it out for a doctor’s perspective on insertion pain, STI risk, and other common IUD-related questions.

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Lena Chen is a blogger, writer and speaker on sex, gender and feminism. As a Harvard undergrad, she authored the blog Sex and the Ivy and her writing has been featured in The New York Times and Newsweek. She currently blogs at The Chicktionary.