Why you get them, how long they last, and what you can do.

When you get an IUD, it’s normal to feel cramping.

“Your uterus is a muscle, and when you place something inside of it, the muscle responds by tightening,” says Lisa Holloway, a nurse practitioner near Washington, DC, who specializes in women’s health. Your body also releases hormones that may lead to pain.

What to Expect When You Get an IUD

When you get an IUD, your doctor or nurse practitioner inserts a small plastic tube into your uterus through your vagina. The IUD is inside the tube. It’s a quick procedure that usually takes just a few minutes.

You may feel cramping and discomfort as it’s being put in. You may feel nauseated or dizzy. Or you may have no symptoms at all.

“Some women have more cramping than others,” Holloway says. “I personally had my first, second, and third IUDs placed at my office on my lunch break. Other women have had such an intense reaction that I have to immediately remove it to ensure the patient is stable.”

If you’ve had children, you may have less cramping because your uterus may be larger and less sensitive.

What You Can Do Before Your IUD Is Put In

To reduce cramping, try these techniques before your appointment.

• Eat, drink, and go to your visit in good shape. If you feel good going into the procedure, you may feel less pain. “Please do not come into your IUD insertion hung over, dehydrated, and having skipped breakfast,” Holloway says. “That’s a recipe for feeling bad.” Drink water and eat something before your visit.
• Try to relax. “When you reduce your fear and tension, you feel less pain,” Holloway says. Try breathing exercises, visualization, or other relaxation techniques. Sometimes simple distraction can help. Listen to music or have a conversation with your doctor while they put it in.
• Schedule your appointment at a good time. Try to schedule your appointment during the last few days of your menstrual cycle. “Your cervix is softened and slightly dilated during this time, which can make insertion easier,” Holloway says.
• Take ibuprofen or naproxen ahead of time. “Ibuprofen is one of the best options for muscle pain from uterine cramps,” Holloway says. “But many people don’t realize it works best if you take it in anticipation of your cramping.” Peace Nwegbo-Banks, MD, an obstetrician and gynecologist at Serenity Women’s Health & Med Spa in Houston, TX, recommends taking 600 milligrams of ibuprofen or 500 milligrams of naproxen an hour before your appointment.

What to Expect After You Get an IUD

You may still have cramping a few days, weeks, or months after getting an IUD. It’ll probably feel a lot like menstrual cramps. You may also have achiness in your lower back.

If you have a copper IUD, like ParaGard, you may have more cramping. But you should feel better after a few months as your uterus gets used to it. Hormonal IUDs, like Kyleena, Liletta, Mirena, and Skyla, tend to cause less cramping.

For some women, cramping lasts 1-2 days after the IUD goes in. For others, it lasts a few weeks. Or it could be as long as 3-6 months before it goes away. You may also have irregular, heavy bleeding for 3 to 6 months.

What You Can Do After Your IUD Is In

To ease your pain after the procedure:

• Take over-the-counter medication. To reduce inflammation and help with pain after your IUD goes in, your doctor may recommend over-the-counter medication like acetaminophen, ibuprofen, or naproxen. Try taking 600 milligrams of ibuprofen every 8 hours for the first day or two. But check with your doctor first to make sure it’s safe for you.
• Practice self-care. Take it slow and easy in the days after you get the IUD. “Hydrate, rest, and spend a few days in your sweatpants if you need to,” Holloway says. Try a heating pad. Apply it gently to the area where you feel cramps. “Exercise and intercourse may cause you to cramp more, so hold off on activity until you feel up to it,” Holloway says.

What to Do if Cramps Don’t Go Away

It’s normal for cramping to last a few months or longer. But if at any point you’re unhappy with how you feel, you’re worried about your cramping, or you notice new or extreme pain, call your doctor.

”Pain can occur as you adjust to the IUD. Other times, it can be a sign of a larger problem,” Holloway says. It’s possible your IUD wasn’t placed properly, it isn’t in the right place, or you have an injury in your uterus from the procedure.

If cramping is severe, lasts longer than 3 months, or you have foul-smelling discharge or heavy bleeding, you should get checked by a gynecologist..