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IUD Insertion

Provided by: PDR.net
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Insertion

The insertion procedure is simple and takes only 5 minutes. Many women feel pain, but some don't. To help you deal with the pain, your doctor may give you a "paracervical block," which consists of injections of lidocaine into your cervix. It will take effect in 2 to 5 minutes.

After the pelvic exam, your physician will determine the size and position of your uterus by using a procedure known as "sounding." He or she will open your vagina with an instrument called a speculum, and wash your cervix with a disinfectant. A long clamp called a tenaculum grasps your cervix and helps steady your uterus, minimizing the likelihood of perforation. Your doctor will push a uterine sound, a blunt rod-shaped instrument, through your cervical canal and into the uterus to determine whether your uterus is big enough to accommodate an IUD (it should be at least 2 and one-quarter inches) and if so, how deep he or she will need to insert the IUD to reach the top of the uterus (the fundus).

At this point, you're ready for the IUD. The doctor folds down the arms of the T-shaped device and loads it into a long tube. He or she inserts the tube into the uterus and releases the IUD by slowly and gently withdrawing the tube. This part of the procedure may cause cramping due to uterine contractions.

The Insertion Procedure

Though a copper IUD can be left in place for up to 10 years with minimal attention, the initial insertion can be a minor ordeal. Done in the doctor's office or clinic, the procedure can be painful; and cramping can continue for up to a day. To insert the device, the doctor will pass a special applicator through the cervix into the lower end of the uterus. As it is pushed upwards with a plunger, the device unfolds to form a "T." A string is left protruding from the cervix to permit later removal.

After insertion, you'll need to put one or two fingers into your vagina to check for your strings. Once you've located your cervix—it will feel smooth and round—you can touch the strings, which feel like nylon fishing line. Every month after your period you should check in this manner to ensure that you haven't expelled the device. You'll also want to make sure you can't feel the hard tip of the IUD coming out of your cervix.

You may have some bleeding and spotting during the first few days after insertion. This is normal, so don't worry. If the bleeding is heavy and constant, contact your doctor to rule out the possibility of infection.

Your first period will probably be a little heavier than normal; it also may come a few days early. You should schedule a follow-up appointment after your first period, sometime within 4 to 6 weeks of insertion. Don't wait longer than 3 months to have a checkup.

Unless you've just had a baby, you can have sex as soon as you like after an IUD insertion. Some doctors recommend using a backup method such as a condom during the first month to reduce your risk of infection. You don't need a backup method to protect you from pregnancy because an IUD is effective immediately.

Adverse Reactions after an Insertion

When the nerves of your cervix are stimulated, your blood pressure sometimes drops, or your heart rate may slow down. This could make you feel dizzy, nauseous, faint, and weak. Although most such reactions are mild and last only 15 to 30 minutes, convulsions and even heart arrest are possible. If your reaction is severe, your doctor may give you a drug called atropine.

What's the Best Time for IUD Insertion?

Because it's dangerous to insert an IUD into a pregnant woman, your doctor may suggest you schedule the procedure during your monthly period. Not only does that eliminate the possibility of pregnancy, but since your cervix is slightly dilated during your period, insertion will be easier.

If you are not pregnant you can have an IUD inserted...

  • Any time during your menstrual cycle, provided you are using another effective birth control method consistently, or have had a negative pregnancy test

  • Any time during your menstrual cycle, if you haven't had sex since your last period

  • Within six days of unprotected sex, if you want a post-intercourse (emergency) contraceptive

If you have just been pregnant, you can have an IUD inserted...

  • Immediately after or within 3 weeks of an uncomplicated first trimester miscarriage

  • Immediately (within 10 minutes) following childbirth—by either vaginal or cesarean delivery

  • Six weeks after giving birth if you are breastfeeding

  • Six weeks postpartum, if you haven't had a period return, are not breastfeeding, and have had a negative pregnancy test

Last Updated: January 1, 2003
2007 Thomson Healthcare. All Rights Reserved.

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