IUD insertion and removal

IUD insertion and removal – what happens at the appointment?

An intrauterine device (IUD) is one of the most effective and long-acting methods of contraception. It is suitable for people of many different ages, including those who have not given birth. An IUD can be either hormonal or copper-based, and depending on the product, its contraceptive effect lasts for several years.

The advantage of an IUD is long-term, reliable contraception that you don't have to remember daily. In addition to preventing pregnancy, a hormonal IUD can ease heavy and painful periods. A copper IUD, on the other hand, is a hormone-free option.

Many people are particularly concerned about the insertion and removal of the IUD. These procedures are usually quick, and you can typically return to your normal daily activities afterward.

When can an IUD be inserted?

In most cases, an IUD can be inserted at any stage of the menstrual cycle, provided it can be confirmed that you are not pregnant and that the IUD is suitable for you. Insertion during or immediately after your period is often a good time.

IUD insertion can also be planned after childbirth or an abortion. After childbirth, insertion is usually performed only after the uterus has returned to its normal state, typically about six weeks later. The timing is decided individually in consultation with a healthcare professional.

Before the procedure, your health status, any existing medical conditions, current contraception, and your personal preferences regarding contraceptive methods will be reviewed. If necessary, a gynecological examination will be performed, and the need for testing for potential infections or STIs will be assessed.

If you are nervous about the IUD insertion or are worried about potential pain, it is a good idea to discuss this with your doctor in advance. If necessary, appropriate pain relief or local anesthesia can be planned.

How is an IUD inserted?

The IUD insertion takes place at the clinic and usually lasts only a few minutes.

During the procedure, the vagina is examined using a speculum, the cervix area is cleaned, and the size and position of the uterus are assessed. The IUD is then inserted into the uterus using a thin applicator. Finally, the IUD strings are trimmed to an appropriate length so that the device can be removed later.

During the procedure, you may feel a momentary pinch, pain similar to menstrual cramps, or a feeling of pressure. The experience is individual. If necessary, the cervix can be numbed with either a numbing spray or an injection.

Before arriving at the clinic, you can take a painkiller that suits you, following the doctor's instructions or the package leaflet. If you are nervous about the procedure, be sure to tell your doctor.

What happens after IUD insertion?

After insertion, you may experience lower abdominal pain, sensations similar to menstrual cramps, and light spotting. These symptoms are usually temporary, but cramp-like sensations may persist for a while. If necessary, pain can be relieved with an anti-inflammatory painkiller, provided it is suitable for you.

Usually, sick leave is not required, but it may be good to set aside some time to rest after the procedure. It is recommended to avoid sexual intercourse, swimming, and baths for the first 24 hours.

The onset of the IUD's contraceptive effect depends on the timing of the insertion and your previous contraception. If the IUD is inserted during your period, the contraceptive effect begins immediately. In other situations, additional contraception, such as a condom, may be needed for seven days. You will receive specific instructions at the clinic.

At the beginning of using a hormonal IUD, you may experience irregular bleeding and spotting for up to several months. Over time, periods often become lighter or may stop altogether. A hormonal IUD can also ease menstrual pain.

A copper IUD, on the other hand, may increase the amount of menstrual bleeding, prolong the period, and intensify menstrual pain, especially in the early stages of use.

How long does an IUD provide contraception?

The lifespan of an IUD depends on its type and the specific product.

Depending on the product, the duration of use for hormonal IUDs is generally 3–8 years. For example, the contraceptive effect of the Mirena hormonal IUD lasts for eight years, Kyleena for five years, and Jaydess for three years. If a hormonal IUD is used as part of hormone replacement therapy for menopause, the duration of use may be different.

The lifespan of copper IUDs also varies by product and can be several years.

If necessary, an IUD can be replaced with a new one even before its expiration date. It is a good idea to confirm the duration of use for your specific IUD at the clinic.

How is an IUD removed?

Removing an IUD is generally a quick and simple office procedure.

A doctor or a trained healthcare professional removes the IUD by gently pulling on the threads visible at the cervix. The IUD folds during removal and passes through the vagina. The procedure is usually quick and causes only a brief pinch or a sensation similar to menstrual cramps.

If the IUD threads are not visible or the IUD cannot be removed in the standard way, further examinations or alternative removal methods may be required.

Please note that contraceptive protection ends immediately after the IUD is removed. If you do not wish to become pregnant, you should discuss a new method of contraception with your doctor in advance.

When should you contact a healthcare provider?

Contact a healthcare provider if, after having an IUD inserted:

• You experience severe lower abdominal pain that increases or does not respond to pain medication.

• You experience heavy or prolonged bleeding.

• You have foul-smelling vaginal discharge.

• You develop a fever over 38°C without flu symptoms.

• You suspect that the IUD has shifted or come out.

In rare cases, an IUD may shift out of place or be expelled. If you notice changes in the IUD threads or experience new pain or unusual discharge, it is a good idea to have it checked by a healthcare professional.

Routine follow-up visits are generally not required solely for the IUD. The need for follow-up is assessed on an individual basis. However, remember to participate in cervical cancer screenings as usual.

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