What IUD Insertion Feels Like

Let’s get one thing out of the way first: it hurt way less than I thought it would.

For years, I had tried to imagine the pain the Internet had convinced me getting an IUD inserted would cause. I’d tried to envision the nightmare cramps I’d supposedly get shortly after the procedure. The pain wasn’t inevitable; as doctors told me, the experience is different for every person. But there weren’t many people like me—virgins getting IUDs inserted for the first time—writing about it online for me to use as a reference point.

I wanted to get an IUD—aka an intrauterine device, a birth control method that’s over 99 percent effective at preventing pregnancy—before I started having sex, because I felt my risks needed to be managed for me to actually enjoy it. I’d spent years reading about contraceptive devices and decided that I wanted to try the non-hormonal copper IUD years (ParaGard in the U.S.) long before I actually got one. The unknowns of sex scared me, but I knew having a plan for birth control—and ultimately choosing and committing to a method—would be the final part of getting myself ready to experience it.

At the end of January, I started the process of getting my IUD—which took far longer than I thought it would because of insurance mixups. My gynecologist was happy to prescribe me one when we talked about it, but I had seen other doctors when I was younger who were more hesitant. Know this: You can get an IUD, regardless of your sexual experience. “It’s safe to get an IUD even if you’ve never had penetrative vaginal sex,” Dr. Gillian Dean, Senior Director of Medical Services at Planned Parenthood Federation of America, said in a statement to ELLE.com. “Your sexual history shouldn’t impact the method of birth control you decide to use.”

Every women’s experience with birth control and IUDs is different and unpredictable, including how painful insertion will be, which is why reading horror-story testimonials will needlessly spook you like it did me. If you need a confidence booster, stick to positive stories about IUD insertion. Here’s one.

What Insertion Was Actually Like

I scheduled my insertion for 4:15 P.M. on a Thursday, with the expectation that I’d leave work a little early and would work from home the next day if needed. I popped four Advil an hour before I went to the doctor.

When I went into the doctor’s office, they immediately had me give a urine sample, to test if I was pregnant. I waited forever in the waiting room with my longtime friend (and IUD-insertion veteran), Alex, who came to distract me from my nervousness with talk of pistachio ice cream and baking—and anything but IUDs.

I changed into a gown, sat on the chair, and saw how tiny the IUD was on the counter. It couldn’t be that bad, right?

I told the nurse I was nervous, and she told me they were going to numb the cervix, and then I’d feel basically nothing. She was right.

This is how Dr. Katharine O’Connell White, Director, Fellowship in Family Planning, Boston University/Boston Medical Center, described the insertion process in medical terms:

The first thing that your doctor does is to place a speculum inside your vagina, and this is an instrument that just holds the walls of your vagina apart so she can see your cervix. Then once your doctor has cleaned off your cervix, they’ll often put a steadying instrument on it to hold it still, and sometimes putting that instrument on can cause a mild cramp. I describe the IUD process as a series of three cramps. A cramp, a cramp, and then a big cramp, and then it’s done. So it’s not like it’s five minutes of constant, excruciating pain—just these little spikes of pain.

Next the doctor will often see how deep your uterus is. They’ll place an incredibly skinny instrument called a “sound” inside, which shows the depth of your uterus, so she knows exactly where to deliver the IUD inside. And then the last step is the IUD insertion itself. The IUD tucks into what looks like a very skinny soda straw, and that passes through the opening of your cervix and the IUD pops out the other end. So the doctor doesn’t need to make any incisions or cuts into your body at all. She’s able to use the natural opening of your cervix that leads to the uterus, where the period blood comes out of, to place the IUD.

I didn’t really feel any cramps, but here’s what I did feel: The doctor felt my uterus to check its shape, then inserted the speculum. This was mildly uncomfortable but not bad. She swabbed to clean the cervix, then gave me an injection to numb my cervix. I didn’t feel much then, either. She sounded the uterus, which was mildly uncomfortable, but again, not too bad.

It took the doctor and her assistant a minute (okay, it was probably less, but it felt like a minute) to get the IUD ready to insert. I kept my eyes closed. Finally, when she put it in, I didn’t notice much; she released it from the inserter, cut the strings on the longer side, and then took the speculum out. And it was over. It hadn’t even lasted five minutes, and I had felt no cramps.

I always get lightheaded after medical procedures (especially shots—it’s more a mental, nervousness thing) so I gave myself the usual 10 minutes of lying down to get back to normal. I ate the last of a Milk Bar Confetti cookie my kind coworker Madi Feller had given me (some people recommended you bring food for after), asked for cold water and drank a lot of it, and then headed out.

I was convinced the numbing was the game-changer, though the experts I talked to stressed that there are no studies definitively proving it changes anything. “The studies that are out about using local anesthesia, which is what the dentist would use to numb you for a cavity, don’t show a significant difference in pain reduction,” Dr. White told me. “So my guess is that your procedure probably would have gone fine anyway.”

The First Two Months With the IUD

Alex walked me home the 10 blocks to my apartment; I was afraid I’d have trouble, but I was fine. I run every other day, and it didn’t really impact my workout schedule: I ran on the morning of the procedure, took a day off from exercising the next day, and then ran again on the second day after. My performance was about the same.

I was told I could have sex a day after insertion if I wanted (LOL—no), and to keep taking Advil as needed for the next 24 hours. Alex advised me to “not be a hero” and just take the Advil if I was crampy, so I did the next morning when I actually had them.

ParaGard can and did make my period crampier and heavier: My first period with it was the heaviest period I’d ever had. There were minor cramps on the first and last days, along with on the day I ovulated (I’d had mild ovulation cramps before). Advil helped manage it, though—honestly, these weren’t awful.

I went back to my doctor one month after my IUD was inserted for a checkup. Then, she stuck a speculum in, confirmed the strings were still in place, and that was it. I don’t need to check the strings; she will.

This has become standard advice: “We used to make women do a string check on themselves after every period, but we stopped that when we realized that it can be really hard to feel your IUD strings, and a lot of women would call their doctor’s office panicking,” Dr. White said. “But if you’re ever concerned about the IUD, you can place one finger inside your vagina up to your cervix to feel the strings, to give you reassurance that the IUD is still in place. If you don’t feel the strings or you’re too uncomfortable to do a check like that, you can always go to your doctor and they can do a quick check for you.”

The adjustment period for IUDs is three to six months. Two months in, I feel the same way I did without the device. There has been some spotting in between periods, like doctors warned me, but it has lessened over time.

First-Time Sex Post-IUD

So what hurt more: getting an IUD or having penetrative vaginal sex for the first time? I bet before the procedure it’d be the IUD; I was wrong. Sex was a 4 on a 1–10 pain scale, compared to the IUD’s 0.5. This varies for everyone, but go figure.

I waited to have sex until three weeks after I got my IUD, and even then, I said yes to my boyfriend knowing that I was always going to be a little scared of the unknown. I thought as soon as I got my IUD I’d be all ready to go. It did give me confidence and reduced my anxiety around sex, but it didn’t completely erase my fear of it. Only time and experience could do that.

I took about every birth control precaution imaginable the first time I had sex (withdrawal, condom, etc.), in part because I still couldn’t believe the IUD was really there, doing its thing when I didn’t even feel it. I was still learning to trust it, and I was grateful to my very sweet boyfriend for making me feel so safe through it all.

My IUD insertion also became part of my process of saying goodbye to my “twentysomething virgin” tag. My abstinence had become a source of empowerment to me (I even wrote about it for Cosmopolitan and ELLE). Waiting until I met the right person was a decision made purely for myself—the same way getting an IUD was.

For every question you have about how IUDs work and what doctors say about getting one as a virgin, click here.