You’ve heard the horror stories. Maybe you’ve lived through one yourself:
IUD insertion pain isn’t just uncomfortable—it’s often excruciating. Yet many healthcare providers still treat it like a minor inconvenience, leaving countless women feeling blindsided and traumatized by what should be a safe, positive procedure.
The truth is that your pain is valid, predictable, and most importantly, preventable. Here’s a look at why IUD insertion is so painful and what you can do about it as a patient.
What Causes IUD Insertion Pain
The cervix wasn’t designed to accommodate foreign objects. Therefore, during insertion, your doctor must dilate your cervix to allow the IUD through.
Your provider uses a speculum to open the vaginal canal, then they measure your uterus with a thin rod called a sound. Next comes the insertion tube containing your IUD, which passes through the cervical opening into your uterus. Some providers may need forceps or clamps to stabilize your cervix during this process, and this can be the most painful aspect.
Each step, however, can trigger intense cramping as your uterus contracts in response to the intrusion. The cervix also contains numerous nerve endings, making dilation particularly sharp and sudden. These aren’t regular menstrual cramps—they’re acute, stabbing sensations.
Why Some Women Experience More Pain
Some women experience little to no pain during an IUD insertion, though this isn’t common. Most people experience pain, but it ranges from intense discomfort to brief agony. Here are the factors that likely affect where on the scale you might fall.
Having Given Birth
Women who’ve given birth vaginally typically experience less pain because their cervix has already been dilated. The tissue has more flexibility and “memory” of being stretched.
Where You Are on Your Cycle
Insertion during menstruation can be less painful because your cervix is naturally softer and slightly more open.
How Anxious You Feel
Muscle tension from fear makes your pelvic floor tighter, increasing resistance and pain. Though it’s important to understand the reality of the procedure, focusing on its brevity and working with empathetic providers can do a lot to control your nerves.
Your Anatomy
Some women have naturally narrow cervical openings or tilted uteruses that make insertion more challenging.
What You Can Do Before Your Appointment
IUD insertion can be painful, but there are things you can do about it. First, ask your provider about pain management options when you schedule your appointment—not the day of insertion. Ask about local anesthetic injections to numb your cervix. While not universally offered, lidocaine injections can dramatically reduce IUD insertion pain. Some providers use topical anesthetics as well. If you think you’re at a high risk of intense pain, do not let a clinic discourage you from seeking these solutions.
You can also take 600-800mg of ibuprofen about an hour before your procedure. Just make sure it won’t interfere with any pain management your clinic will provide. This anti-inflammatory medication helps reduce cramping.
Another option is taking a cervical softening agent, such as misoprostol. This medication, taken a few hours before insertion, helps relax and slightly dilate the cervix. Not all providers offer this, but many will prescribe it when asked.
Discuss conscious sedation options. Some clinics offer nitrous oxide (laughing gas) or oral sedation medications for anxious patients or those with previous traumatic experiences.
Your Pain Matters
IUD insertion pain isn’t something you should just tough out and accept as inevitable. Medical procedures should prioritize patient comfort, and contraceptive care should be no exception. With this information in mind, you can prepare for an IUD insertion with an informed mindset and advocate for the care you deserve.
This article was written for WHN by Casey Cartwright, a passionate copyeditor highly motivated to provide compelling SEO content in the digital marketing space. Her expertise includes a vast range of industries, from highly technical to consumer and lifestyle-based, with an emphasis on attention to detail and readability.
As with anything you read on the internet, this article should not be construed as medical advice; please talk to your doctor or primary care provider before changing your wellness routine. WHN neither agrees nor disagrees with any of the materials posted. This article is not intended to provide a medical diagnosis, recommendation, treatment, or endorsement.
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