By the time I’d made the decision to get an intrauterine device (IUD) last year, I thought I was completely prepared. I’d done all the research, read all the articles, and talked to my OB/GYN about what would happen. But when it came time to get it done, these were the things I didn’t expect.
It’s ridiculously quick. The time between first putting my feet in the stirrups to pulling my pants back on didn’t total more than 10 minutes, and that included a lot of chit-chat between me and my nurse practitioner. I expected that it would take a good bit longer to prepare everything and make the proper adjustments so that the IUD would fit perfectly into place, but in reality, the whole appointment was probably shorter than my average yearly gyno visit.
You have to provide a urine sample. I decided to pee before I left for my appointment because I didn’t want to be struggling during the car ride there, but that turned out to be a mistake. Your doctor or NP will need you to take a pregnancy test before the insertion, and that means they’ll require a urine sample. I had to be That Girl who spent 10 minutes in the bathroom trying to squeeze out any possible droplets that I could, so if you want to have a more pleasant experience, I highly recommend just holding it until they give you that little plastic cup.
Not all IUDs will alter your periods. IUDs are all long-term forms of birth control, but that doesn’t mean you can’t find one that matches your personal preferences. For example, if you’re looking to tame your intense periods (like I was), a hormonal form of IUD like Mirena might be your best choice. If you’re worried about the effects of hormones on your body or want ten years of protection instead of five, ParaGard might be a better option. Talk to your doctor to see which IUD would best suit your needs.
Your uterus is going to get pinched. I wasn’t prepared for all the tools that would be laid out on the table before my procedure, and the most terrifying one by far was the tenaculum. My NP explained that the extra-long pincers would be used to, and I quote, “hold my uterus in place” while the IUD was inserted. To me, this was the worst part of the experience — I hated the thought and feeling of that clamp pinching onto one of my organs. It was more psychological than anything, but I still get the shivers when I think about it.
It hurts REALLY bad. I’d heard all the stories of people who’d gotten IUDs, and all of them were very honest about the fact that it hurts. But I had a high pain tolerance (so I thought), and I assumed that I would be fine. I was mistaken. The tenaculum pinching my uterus triggered a sensation that felt like the worst cramps I’d ever had. I immediately started sweating and clenching my teeth together to keep from crying out, and the NP had to gently remind me to relax to help keep my cervix from tensing up. The good news is that the pain stopped almost immediately after the tenaculum was removed, but for a solid minute or two, things were a bit rough.
You might feel sick. Again, I thought I was a badass who wouldn’t be fazed by any of this, but once my IUD was in, I felt lightheaded and nauseous. My NP assured me that this wasn’t uncommon and that if it got worse or persisted more than 10 minutes or so, I should let the clinic staff know so that I could be taken care of accordingly. My own discomfort only lasted a couple minutes, so once I was sure I was safe to drive, I got dressed, drank some water, and headed home without incident.
Expect blood. After your procedure, you should be given a sanitary pad to put in your underwear. My NP told me that the bleeding was from that damn tenaculum, but also that getting a hormonal IUD can make your period start early or even give you an extra period until your body gets used to it (more on that in a minute). The bleeding wasn’t horrendous, and I only needed one pad, but everyone’s body is different and you shouldn’t panic if you experience more or less bleeding.
You’ll probably deal with cramping afterward. I was warned that I might experience “light cramping,” but it was a bit worse than that. Every day around the same time (usually early evening), I started getting what felt like menstrual cramps, but there was no blood. The pain also started happening whenever I’d eat a hearty meal, and I assumed it was from my fuller digestive system putting pressure on the IUD. Because I knew generally when I’d start cramping, I started taking a couple ibuprofen about thirty minutes beforehand so that I could reduce the pain. Talk to your doctor to see what the best pain management system would be for you if you start experiencing the same thing.
Your periods might get weird. I knew going in that my periods might lighten or become irregular if I got a hormonal IUD, but it was still a bit annoying to have to deal with so much spotting. My first few periods after the procedure were odd — sometimes I’d get cramps days before they started, sometimes I’d have one day of heavy bleeding and then three days of super light spotting, and once I had a period that lasted almost a month (only to be followed by two months of super short, super light periods). If you don’t already use one, I highly recommend trying out a menstrual cup in the months following your IUD insertion. It prevents you from having to worry about pads, tampons, and stained underwear until things calm down.
You might have to go back in for adjustments. In some cases, your IUD might shift after insertion, which can be uncomfortable or even painful. There are also long strings that are attached to the device to help with adjustments and removal, and although I knew they were there, I didn’t know how long they were. At least, not until my boyfriend asked me why it felt like I had fishing wire in my vagina. Awkward. The strings shouldn’t be uncomfortable to you or your partner during sex, but if they are, you can go back in and have them trimmed.
It’s so, so worth it. The IUD experience has been an interesting one, but the lighter periods it gave me (and of course, five years’ worth of no pregnancy scares) has been worth it. If at any time I decide to change my mind and have babies, all I have to do is go in and get it removed, and I can start trying to get pregnant right afterward. Even knowing how much it hurt at first wouldn’t be enough to dissuade me from doing it again, and I really encourage anyone who wants easy birth control to consider an IUD.