Other Questions

When is it inserted?

An IUD is inserted by one of our physicians at a short clinic visit. The best time is just at the end of your period, but anytime is fine, as long as there is no risk of pregnancy. If you are using the IUD for contraception, we recommend that you abstain from sex from your period until the insertion day, unless you are using another reliable form of birth control (pill, patch, ring, depo shot, or implant). The copper IUD is immediately effective, but the IUS will take 7 days to be effective unless it is inserted while you are on your period.

How is it inserted?

The doctor checks the size and position of your uterus. They put a speculum into your vagina to see the cervix, and may offer local anesthetic if you wish. They hold the cervix, checks that they can get through it, and then inserts the IUD to the top of your uterus, usually about 7 cm. The physician will then cut the string.

Depending on how the insertion went, we will often do an ultrasound during the same visit or during a visit a few weeks later. Ultrasounds aren’t necessary to have a successful insertion, but are a tool we can use to ensure the device is in the correct position. If you have any questions about having an ultrasound to confirm the position, please ask the physician doing the insertion.

Are there any risks?

No medical procedure is without risk. For IUD insertion, the risks are small, but include expulsion, pregnancy, infection and perforation. Expulsion is the most common, occurring 1 - 5 % of the time. Usually this happens within the first few months. Pregnancy is rare, about 1 in 100 for patients with a copper IUD, and about 8 in 1000 for patients with the Mirena IUS. Risks of infection are only high for 3 weeks following insertion, and are more common if you already have a vaginal infection or STI, so we recommend screening at the time of insertion. Rates of infection are less than 1 %. Perforation, or putting the IUD through the uterus instead of inside it, is uncommon, about 1 in 1000 insertions. This happens at the time of insertion and often noticed at the time. An ultrasound following the insertion can help us confirm the IUD is inside the uterus. If perforated, the IUD must be removed, sometimes requiring laparoscopic surgery.

With the Copper IUD, your first few periods will likely be a bit heavier and more painful. This tends to improve with time.

With the Levonorgestrel IUS, most people have unpredictable bleeding and spotting for the first 3 - 6 months. This is mostly light bleeding and not harmful. This usually stops by 6 months.

Does it hurt?

Sometimes. If you have not had a pregnancy with a vaginal delivery, your cervix might be tight and cause you to feel a strong cramp when the IUD is passed through the cervix into your uterus. Most people have a strong twinge but feel fine in a few minutes. Occasionally, some people might feel queasy or lightheaded. Taking ibuprofen before you come will help, and we recommend bringing someone to drive you home if you are concerned about pain.

We do offer local anesthetic (a cervical block) for insertions. If you want one, please ask your physician about local anesthetic.

Please click here for more information about other methods to reduce IUD insertion pain.

Are there other benefits to an IUD / IUS?

Because it has medication, the IUS is often used to control troubling period symptoms such as heavy bleeding and harsh cramping. For this reason, some people are not using the IUS for contraception, but for period control.