What to Know About IUD & IUD Insertion

(Tina Dawn/ VM-Med) — An IUD is a popular type of long-acting, reversible contraception that provides birth control for three to 10 years, depending on the type that you choose. The small, flexible, T-shaped device is inserted into the uterus through the vagina. IUDs prevent pregnancy by reducing the ability of sperm to reach the egg for fertilization. If the sperm and egg don’t meet, pregnancy can’t happen. Hormonal IUDs can also change the lining of the uterus, making it difficult for a fertilized egg to stick to the lining to start a pregnancy.

Not only are IUDs 99 percent effective in preventing pregnancy, they’re also easily reversible. That means that you can remove your IUD at any time and immediately start trying to become pregnant. IUD clinics, as well as most health clinics, offer consultation and insertion services.

Hormonal and copper IUDs

There are essentially two types of IUDs on the market: copper and hormonal. Copper IUDs (Mona Lisa, Nova-T, etc.) are effective against pregnancy immediately when inserted, while hormonal IUDs (Mirena, Kyleena, etc.) can take seven days before they become effective, unless they are placed in the first seven days of your menstrual cycle. In the meantime, you can use condoms or another kind of birth control to prevent pregnancy.

Copper IUDs work by introducing a copper wire coiled around the IUD, producing an inflammatory reaction that is toxic to sperm and eggs and therefore prevents pregnancy. Hormonal IUDs contain progestogen, a synthetic version of the hormone progesterone made naturally by the ovaries. You can have an IUD inserted at any time, as long as you aren’t pregnant, and you don’t have a pelvic infection.

Not everyone is a good candidate for an IUD. If you’ve experienced abnormal Pap smear test results, have a history of cervical or uterine cancer, or are at higher risk of STIs, an IUD may not be for you. While IUDs are some of the most popular forms of birth control because they’re an extremely safe, long-term, hassle-free form of birth control and offer effective pregnancy prevention, there are still minor risks to getting an IUD. It’s best to consult with your doctor before making a final decision.

How is an IUD inserted?

The hormonal IUD is inserted through the opening of the cervix inside the uterus by a trained doctor or nurse. You can choose to have a local anesthetic or sedation while it is inserted, but it’s best to notify the clinic in advance. The IUD insertion itself usually takes no more than 15 minutes.

The nurse or doctor will put a speculum into your vagina and then use a special inserter to put the IUD in through the opening of your cervix and into your uterus. Once the IUD is inserted a string about 1 or 2 inches long will come out of your cervix and into the top of your vagina. The string is there so a nurse or doctor can remove the IUD later.

If you happen to feel the string, don’t pull on it because you could move your IUD out of place, reducing its effectiveness. You can periodically check to ensure it remains in place.

Does getting an IUD hurt?

One of the most common questions women have about IUDs is if insertion hurts. Most medical professionals will tell you that it depends on the person’s pain threshold and each IUD insertion is unique. According to a study from the British Medical Journal, roughly eight in 10 women feel their insertion pain is either moderate or severe. Patients may experience anything from mild discomfort to severe cramping and considerable pain.

Being well-educated on the topic and knowing what to expect is important, as it manages patients’ expectations and helps them make the best decision for themselves.

If you’re about to have an IUD inserted, you can take over-the-counter painkillers before or after the procedure to help reduce any pain you might experience. You may also ask that a local anesthetic be used before the IUD procedure begins to make it more comfortable.

Some people experience dizziness during or right after the IUD is put in, and there’s a small chance of fainting. Healthcare professionals usually advise patients to ask someone to come with them to the appointment so they can accompany them home later.

While it’s perfectly normal to experience some painful cramping, spotting, or backaches after the procedure, if you experience bleeding, excessive pain, feeling the IUD in your cervix or vagina, fever or chills, you should contact your healthcare provider as soon as possible.

New U.S. pain management guidelines may inspire Canada

Recently, the United States Centers for Disease Control and Prevention (CDC) released updated guidelines for clinicians on how to help patients manage pain from IUD insertion and encourage healthcare providers to counsel patients on pain management options. Some U.S. clinics even offer sedation for IUD insertion.

Some offer a local anesthetic, in the form of a spray or by needle in the cervix, although it’s not always useful or routine since the anesthetic doesn’t help that much with post-insertion uterine cramping, although it can help reduce the pain during the procedure. It’s recommended that the patient request the anesthetic in advance since it’s not always available.

The U.S. guidelines have prompted many provincial health officials in Canada to now offer some pain-management options and suggest patients take acetaminophen, ibuprofen, or naproxen if needed.

IUD options

Mirena is a popular type of hormonal IUD that has been shown to prevent pregnancy for up to eight years. It’s also often prescribed by people experiencing heavy periods and excessive bleeding, suffering from endometriosis, or those dealing with fibroids. Mirena is used to decrease bad menstrual pain and pain related to the growth of uterine-lining tissue outside the uterus, called endometriosis.

The Mona Lisa IUD is a copper IUD that’s popular in Canada and offers an alternative to hormonal contraception. It can safely prevent pregnancy for up to five years.

Kyleena is a low-hormone IUD that can prevent pregnancy for up to five years. Kyleena is slightly smaller than Mirena and has a lower dose of the hormone, progestogen. Both Mirena and Kyleena are highly effective in preventing pregnancy, but studies have shown that there are typically fewer bleeding or spotting days per month with Mirena than with Kyleena.

At the end of the day, IUDs are a popular form of birth control because they offer extremely safe, long-term, hassle-free, and effective pregnancy prevention. Educating yourself on the different types of IUDs, the insertion method and ways to minimize pain allows you to make better health decisions for yourself.

Our team at VM Med’s Gynecology Centre supports every aspect of our patients’ gynecological health throughout the course of their lives. We offer a welcoming environment and specialized counseling and treatments on a wide range of issues, including menstruation, menopause, screening and treatment of sexually transmitted diseases and genital cancers, and more. Our services also include insertion and extraction of IUDs.

For more information on your sexual wellness, family planning, contraceptives, and STI screening you can read our extensive archive of VM-Med blogs, including Types of Contraceptives – Choose the Right Birth Control for You or Women Need to Prioritize their Own Gynecological Health.

Still have questions? Book a consultation with our experts.