An IUD is a flexible, T-shaped gear with strings tied to the end.
Its shape helps it sit in your uterusthe arms of the T anchor it into place.
Its tinybetween 1.18 to 1.42 inches long, which is about the size of a standard paperclipbut powerful.
Illustration by Justin Metz
There are also nonhormonal IUDs, like Paragard, in which copper acts as a spermicide.
Its not something you have to remember to take (like the pill or an injection).
And most health insurance plans cover both hormonal and nonhormonal IUDs.
Illustration by Justin Metz
Mine did, entirely.
For me, this was a godsend.
So there I was in stirrups, breathing through sensations Id never felt before.
Sure, my doctor warned me that I might feel cramping pain.
Yes, I took two ibuprofen before the appointment, as instructed.
Still, I shed a few tears.
But the discomfort was worth it.
My IUD helped protect me from pregnancy through my college years and beyond.
I was proud of my decision to take charge of my reproductive health and safety.
My second IUD didnt last as long.
(This condition is calledAshermans syndrome, she told me.)
From a patients perspective, these stories can help with expectation-setting, anxiety management, and decision-making.
Others said they had agonizing cramps and bleeding both during and long after insertion.
It seemed like there was no universal experiencegood or bad.
Numerous factors influence a persons IUD experience, including anatomical differences, says Dr. Sekhon.
Uteruses come in all different shapes, sizes, and orientations.
Personal medical history can also have an impact.
Then, theres your pain threshold.
In August 2024, the C.D.C.
released updated recommendations for contraceptive use, including IUDs.
First and foremost, ask questions.
Many of the peopleAllurespoke to wished their doctors had been more forthcoming about options for pain management.
Also, insurance may or may not cover certain forms of pain management.
Be clear and specific when communicating your needs and expectations to your health-care provider, says Dr. Jackson-Bey.
If something is unclear, dont hesitate to ask for more information.
Its important that you fully understand the process.
If you feel uncomfortable or believe your concerns arent being addressed adequately, let your provider know.
If youre still not being heard, remember that its also okay to leave.
Your doctor will then measure the depth of your uterine cavity to confirm the exact placement of the IUD.
(You might feel some cramping here.)
Next is the actual insertion.
Your doctor will insert the rig into your uterus using a flexible tube.
(This is where youll feel the most uncomfortable.)
For some people, this time can mark the start of when problems arise.
While IUDs are typically safe and effective, they do come with risks, says Dr. Sekhon.
Some patients experience spotting between periods and unexpected changes in menstrual flow.
They also often resolve without the need for treatment.
And remember: IUDs prevent pregnancy, not STIs.
Per my friends instructions, I lied and said I was 21 and engaged to be married soon.
It would be seven more years before the right to use birth control was extended to unmarried people.
Those who dont want you empowered know this.
There are also reasons aside from birth control that people might choose to use an IUD.
The precise mechanisms behind this reduction are not yet fully understood, she adds.
(IUDs that release levonorgestrel include Skyla, Kyleena, Liletta, and Mirena.)
The bill was amended a month later after pushback.
In June, Senate Republicans blocked a bill that would makeaccess to contraceptiona federal right.
Here, 27 people share their IUD experiencesthe good, bad, and everything in between.
She told me that a copper IUD was my best bet.
It was the only non-barrier, 99% effective, non-estrogen birth control method on the market.
I got the Paragard when I was 19 and a sophomore in college.
Id started being sexually active after my senior year of high school and used condoms for protection.
Id take excruciating cramps over having a seizure any day of the week.
All the heavy bleeding in the world is worth it for my safety.
My insertion wasnt bad at all.
My doctor gave me a local anesthetic (a paracervical block) and Advil beforehand.
She was like, Wow, you must have a high pain threshold.
After the appointment, I had some mild cramping and light discomfort.
My mom drove me home and I remember the ride going smoothly.
My new gynecologist has advised me to talk to my neurologist about other non-hormonal options.
Still, Im doing my own research.
She also did blood work for my husband, which she said came back fine.
She then tried to convince me to do an egg retrieval and pursue IVF, which didnt feel right.
So I left and decided to pursue other avenues of getting pregnant.
I was doing acupuncture, eating well, and exercising.
I was trying not to be stressed.
I had a fitness watch tracker measure my temperature so I could track when I was ovulating.
I was doing everything.
Within one visit, she told me, You have so much scarring in your uterus.
No wonder you’re not getting pregnant.
She told me my IUD could have caused inflammation that led to the scarring.
It could have scarred me during the insertion or removal processwhich for me, wassopainful and difficult.
Regardless of the specifics, she was confident that it was the IUD that caused the scarring.
She scheduled me for a procedure to scrape the scar tissue from my uterus.
My doctors had to put me under general anesthesia, so I didnt feel a thing.
Then I had to be on hormones for a month to help regrow the tissue.
After I finished the estrogen, it took me two months to get pregnant.
Now, I have a healthy 10-month-old baby.
IUDs need to be considered a risk factor for uterine scarring.
I took not being able to get pregnant so personally, as if it was my failure.
She thought that IUDs give you a level of freedom that other types of birth control don’t.
My first Paragard lasted for four years before I started to feel something was wrong.
I was running more and I noticed I was feeling some pain.
It was inconsistent, but I was also noticing some spotting.
I asked, Can I get it checked?
They said, No, we don’t do that.
You’re probably dehydrated.
The last time, I asked them to document the pain in my chart.
Because I wasnt due for a pelvic exam, I was told Id have to pay out of pocket.
So I pushed them to give me an STI test, which I knew would be covered.
That was the first time she had believed that I had a problem.
Within an hour, my IUD was taken out completely.
It was never comfortable.
And then a month later, I got another Paragard.
For my last Paragard and my Skyla, I found a new ob-gynand I like her.
There was a level of comfort I had with this doctor putting in my IUD.
She wasnt phased by the fact that not all uteruses are perfectly symmetrical.
She was focused on the person in front of her, not the theoretical diagram she learned in school.
Shes an Asian woman and Im a Black woman.
And now I don’t actually see any white practitioners.
They’re all women of color.
I think that matters.
Each time I see her, I feel heard.
Her advice reflects my needs and wants.
Because my migraines have been under control, I felt liberated to use hormonal birth control.
I’ve had a wide range of experiences with my IUDs.
My IUDs gave me a level of control that no one could take away.
Now, I can have intentional conversations about being pregnant when I’m ready and comfortable.
The entire time I had the IUD, my period was extremely light and almost nonexistent.
I barely needed a pad or tampon.
Everybodys body is different, of course, but for me this is a great form of birth control.
I really see no downsides other than slight discomfort during removal.
I was so naive.
I thought it was going to be so quick and easy.
As it was inserted, I legitimately saw stars like a cartoon character.
It felt like I was having the worst period cramps of my lifemultiplied by two.
I sat on the toilet, clutching a water bottle my doctor gave me like a stress ball.
It didnt help with the pain.
Ultimately, I had to call my parents to pick me up from my appointment.
Yes, it sounds daunting.
But getting an IUD was one of the best decisions I’ve made.
It changed my life.
I recommend getting an IUD to anyone who might be nervous about getting pregnant.
I found it to be a responsible decision for both me and my partner.
JILL B., 51, Philadelphia
I got my first IUD after my third child was born.
My husband and I agreed that we didnt want more children.
But he wouldnt get a vasectomy.
I dont even remember why he wouldnt.
I was 37, and hadnt taken the Pill since before I got pregnant with my first child.
I didnt want to go back on it.
My doctor recommended a nonhormonal IUD.
The insertion process was basically nothing.
I honestly have no memory of it, so it couldnt have been very uncomfortable.
The same kind of off I felt in the early days of my pregnancies with my three children.
A friend said, Just take a pregnancy test.
You cant be pregnant but itll give you peace of mind.
The test was positive.
You’re definitely pregnant.
I did not want a fourth child.
So Im thinking, Okay, this will probably just resolve itself.
My husband and I get to the ER.
Theyre doing an ultrasound.
They see the babys heartbeat; its in my uterus where it should be.
And then they start looking for the IUD.
I didnt want to be pregnant, but I didnt consider ending the pregnancy.
I was bitter at my husband for not getting a vasectomy, though.
And angry at the doctor whod put in the IUD.
I wanted to punch him in the face.
Dont you think I wouldve remembered him telling me that?
And then I would have checked the strings.
The only thing I can think is that it fell out.
Now, I cant imagine not having our fourth child.
He completes our family.
After he was born, I had my tubes tied.
EMMA Z., 25, Denver
It took me a while to decide I wanted an IUD.
I had a boyfriend and I was having sex frequently and my period was already irregular.
I wanted an IUD for peace of mind.
At most, I felt a little bit of pressure.
I was offered no pain medication, but took 800 milligrams of ibuprofen about an hour before.
About eight hours after the insertion, though, I was in immense pain.
I had uterine cramps that were so intense and lasted so longI thought I was going to pass out.
I even had sex the next day and it was painless.
Two years later, I still have my copper IUD.
So I made an appointment for a hormonal one.
I didn’t have trepidation going to my appointment.
I usually face situations with a vigorous energy, ready to tackle them.
But when I walked into my room, I felt a little unprepared.
I was surprised to see so many people.
There was a doctor and two or three nurses.
The room was also a little more surgical than Id expected.
I wasnt prepared for how much it would hurt.
I was sweating so much and I eventually passed out from the pain.
I already felt embarrassed for passing out, and hearing that comment made it worse.
I had pain for about a month, which eventually turned into a dull ache.
I have friends who love their IUDs, but I feel like it just didnt work for me.
VALERIE A., 59, Albany, Georgia
I used an IUD throughout my reproductive years.
I first heard about IUDs when I was in medical school, studying to be an ob-gyn.
I wanted a long-term birth control method, so I thought this would be the best choice for me.
I took it out to have my second child.
The insertion was painless.
I wasnt offered anything for pain, but my doctor recommended I take a Motrin and I did.
It felt like a pinpricka very small sensationand I didn’t have any problems at all.
All of my experiences with IUDs were like this.
My second IUD was a Mirena, which I got in 2001.
I had the third IUD while I hit menopause and recently had it removed.
There are some factors that you have to consider, like your lifestyle.
That changed over the last year and I talked with my doctor about birth control options.
I don’t like thinking about the fact that I have a uterus every day.
It feels foreign to me.
I don’t want to think about the fact that I could get pregnant.
I dont want to think about the fact that I have a uterus.
A lot of people don’t know that when you’re ontestosterone, you could still get pregnant.
I’m very, very fortunate that my primary care provider is actually a trans man.
My doctor referred me to a gynecologist to have an IUD consultation.
The ob-gyn was a cis man who has had some exposure to trans patients, but not a lot.
In no way was he not supportive.
Here are the risks involved.
That was pretty emblematic of my experience with medical professionals and most other trans people that I know.
The insertion was 10 out of 10 painful, but Im glad I did it.
The experience has been more uncomfortable than I expected.
But taking daily oral contraceptives [forced me to].
Its wonderful for some people.
It is just not right for me.
The IUD is a reliable solution for contraception that doesn’t involve that bang out of reminder every day.
I went to my universitys medical center, which was a teaching hospital.
We’re all adults.
But I was putting all my brain power into not moving and trying to be as easy as possible.
Part of me didn’t want to seem like a wimp in front of this group of people.
I lay there grinding my teeth and just breathing in and out and hoping it would all be over.
It’s painful, I can feel it, my partner can feel it.
This isn’t right.
At first, they blew it off.
They asked me what his size was and I was like, That is definitely not the issue.
I was adamant about being seen.
I told them I wanted it removed and to get another form of birth control.
I was so lucky that I didn’t.
I was mad because I realized that I had been misled every step of the way.
A day later, I had the IUD removed at an ob-gyn office I was referred to.
My advice to someone who is getting an IUD is to go to a doctor that you trust.
Know that at a teaching hospital, the doctors will take their sweet, sweet time.
Despite that experience, I decided to get another IUD.
This was game-changing for me.
This time, I didnt feel any pain during insertion.
Unfortunately, about three to four weeks later, this IUD also dislodged and I was in excruciating pain.
IUDs arent right for me.
My doctor agrees, saying that my body wants to reject them [for some unknown reason].
NAYIRI K., 44, Boston
I have always had really long, heavy periods.
I couldn’t tell you how many pads or tampons I went through.
It made me anemic, so whatever I could do to shorten the periods, I would.
She also told me to take some Advil at home.
The insertion process itself was very difficult for me because I was very stressed out and nervous.
I’d never done anything like it.
My nurse said, I will sit with you and hold your hand, if you need it.
I consider myself to have a pretty high pain threshold, but I definitely needed to hold her hand.
I always made sure I had a panty liner or something with me, just so I was prepared.
Around the time Id normally start bleeding, there was nothing.
Thanks to my Mirena, I immediately stopped getting periods for the next six years.
I wanted to toss Mirenas off of the rooftops like confetti.
This Mirena caused cramping and bleeding after sex.
With my fourth Mirena, my periods became more erratic.
My mother had a history of fibroids, so perhaps it was genetic.
I think my body just became inhospitable to a Mirena and only hospitable to fibroids.
I still think fondly of my Mirena.
My first one truly was a game-changer.
I suggested it to friends because if it works for you, it works really, really well.
I researched IUDs for at least four months.
This included reading medical papers, studies, brochures, and news articles detailing firsthand accounts.
However, that was far from the reality.
But I believe that as a Black woman, the pain was greatly downplayed and ignored.
It took nearly a year for me to feel settled with the IUD.
I decided to keep it because I no longer have to be concerned with taking the pill daily.
It’s a very effective form of birth control andlowers my risk of getting cervical cancer.
I really feel comfortable knowing that its there and I dont have to really worry about it.
LIN C., 34
I was nervous on the day of my appointment.
I took Motrin, but I still felt cramps and dull aching during the insertion.
I found that communication helped with my discomfort.
I never really had side effects that I experienced when on other birth control options.
EMILY L., 29
I never actually got my IUD because my insertion appointment went so terribly.
I was trying to get the Kyleena when I was in college in 2017.
The insertion process was miserable.
A nurse first used a metal tool to attempt to measure my cervix.
I immediately started cramping and felt extreme pain.
I was incredibly embarrassed and started to tear up.
To be met with her reaction was very discouraging.
She left the room and returned with another nurse who asked if I wanted to have another go.
Id recommend that anyone interested in the IUD do their research on their providers.
My insertion appointment felt complicated and longer than it should have been.
I felt so exposed.
For a month and a half after the appointment, I bled and bled and bled.
After I got my IUD, I developed more ovarian cysts and sex became painful.
Theres a bitterness about having to go through something this traumatizing.
Go with who you feel is listening to you.
Both experiences were brutaldownright barbaric.
I remember feeling faint and the blood draining from my face as my first IUD was inserted.
For my second IUD, I nearly vomited from the pain.
After all was said and done, my doctor said, Its ridiculous, isnt it?
I would love to give my patients pain meds for this.
I’ve recently heard some lucky people have had their providers offer lidocaine.
I love the peace of mind it has afforded me.
It has been freeing.
MARIA D., 34, New York City
I have had two IUDsthe Mirena and the Skyla.
The insertion for both was deeply uncomfortable.
I had to take off work for two days because of cramps and discomfort.
All was well until my first period.
Two days before my period started, I got the most intense cramps of my life.
It felt like someone was twisting a knife in my uterus.
I was brought to my knees; I had to lay on my stomach and scream into a pillow.
Finally, after a year, I got the IUD removed.
Two years later, I tried again with Skyla, which is smallerI thought that would help.
By this point I had a new gyno who closely monitored the situation.
It was placed (again, no pain meds) and like clockwork, the cramps returned.
I email my doctor all the time.
She’s probably sick of me by now.
I’d also consider your previous relationship with birth control.
Which leads me to my final pointlisten to your body!
If something doesn’t feel right, speak up.
And if they tell you to wait it out and that doesn’t feel right, advocate for yourself.
In this case, that is more important than what your medical provider may suggest.
Not really, of course.
I will obviously have it removed, but I do not look forward to that day.
Instead, the insertion process was intense, painful, and emotional.
I have one child, who I gave birth to 15 years ago.
Some of the pain that came with the IUD insertion was similar to how things feel post-birth.
The main difference, though, was that when I had my daughter I had an epidural.
With the IUD insertion I had only taken two ibuprofen.
There was a lot of blood.
I bled for two days.
But after that, there were no other side effects.
That’s been the silver lining with Mirena.
Though the physical pain subsided, the emotional and mental pain from the whole experience have stuck around.
I am not a dramatic person: I am very objective and deal with things calmly and logically.
Nothing about that process made sense to me.
Why not just be honest?
Why not prepare a patient properly?
Why not show any sort of empathy?
It was a cold experience and I’m so sad that women have to go through it alone.
My periods were worse than when I wasn’t taking any form of birth control.
I had severe GI upset for the entire time that I had the IUD.
Multiple medical professionals tried to convince me it was simply my endometriosis worsening.
I switched back to my low-dose combination birth control pill and my GI upset resolved immediately.
About 80% of them had pretty innocuous or positive things to say about the IUD.
The other 20% had either horror stories or less-than-stellar experiences.
But isnt that always the way?
It took about five months for me to get an appointment.
My gyn is also an extremely beloved ob, and he was booked out for ob visits.
My appointment was quick and relatively easy.
The speculum part was the most uncomfortable to me, but it wasnt an overly painful experience.
I bled a lotalmost daily for about a month and change.
Thankfully, my doctor and many friends warned me that this might happen.
There was some cramping that came with the bleeding in the very beginning.
Once the omnipresent bleeding and spotting subsided, it was fairly smooth sailing.
I never really know when Ill get my period, but I have sort of gotten used to that.
And truthfully, I likely only have a few more years of periods anyway before I transition into menopause.
My first was a Kyleena, which my body expelled just six months after Id gotten it.
I was at a party at a friends house and I suddenly got a really, really bad cramp.
It probably lasted about five seconds.
The answer to anything related to women and their periods is birth control: You have PCOS?
You have heavy bleeding?
You’re cramping too much?
The whole answer is birth control.
It makes me wonder, Is birth control the best answer or is it just a widely accepted answer?
Looking back on it, I was not prepared for the pain of the insertion.
I was surprised at the internal pulling and tugging.
My doctor hadnt spoken to me about it and I felt very ill-informed.
I didnt have any pain medication.
I had no idea it was available.
I remember having discomfort and cramps that kept me from going back to work after the insertion.
I have a female ob-gyn now, but the one who inserted my first IUD was a man.
I was also looking to regulate my body after being on oral contraceptives for cramps since high school.
After asking friends and consulting with my doctor, I made an appointment to get the Paragard.
Almost a year later, I ended up being in the 1% who got pregnant.
I was 23, and my doctor told me my IUD had shifted.
I didnt feel it.
I had the IUD removed and got an abortion.
My decision to get one was immediate.
I was lucky to have a long-term partner who was supportive through the process and on the same page.
COLLEEN R., 29, Portland, Oregon
I started thinking about the IUD in 2016.
I was living in Florida around the time of the Trump election.
I was also really young at the time and not ready to have children anytime soon.
About a year later, I ended up moving to Portland and getting the Mirena.
I wasnt nervous about my appointment.
I do my annual appointments and I’m fairly used to the speculum.
It’s not pleasant, but I already knew what that feeling was like.
My doctor also warned me that it might be painful and described it to me as intense period cramps.
I would characterize my whole process as a pretty privileged experience.
It wasn’t a fancy doctor or anything like that, but this procedure was covered by my insurance.
I really liked my gynecologist, and it was a women-focused clinic.
The rooms were really nicely decorated.
I also had my partner at the time there with me.
So with all those factors, it was anticipation more than nervousness.
It didn’t take that long.
It didn’t feel like I was going in for surgery or anything like that.
It just felt like an ob-gyn appointment.
The first year was great because I no longer got a period.
Because Im really activeI camp and hike a lotit’s just really inconvenient to have periods.
And since its expensive to buy tampons, I was also reveling in the savings.
The IUD was one of the best health-care decisions I’ve ever made.
I always recommend looking into IUDs, but I know that they’re not for everybody.
My IUD offers me a lot of freedom, more than I had before.
Cassie Q.
*, 33, Brooklyn
I had the copper, nonhormonal IUDthe Paragardfor nearly 10 years and loved it.
However, the warnings include that you’re free to be more susceptible to infections.
What I didnt realize was that itmade me more susceptible toanyinfectionentering my body.
The doctors cultured the bacteria but could never pinpoint what it was, nor the cause.
Either way, they said having my IUD made me more susceptible to this infection.
I had it removed.
Would I still recommend the copper IUD to others?
Potentially, but as with any medical gadget there needs to be more education for the patient.
CHERIE W., 36, Brooklyn
I had my first IUD for five years without incident.
I have a love-hate relationship with IUDs.
I love that Im very unlikely to get pregnant and that my period is minimal.
*Names have been changed for privacy
Illustrations by Justin Metz
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