Care After Intrauterine Device (IUD) Placement

We partner with you to prevent and relieve pain as completely as possible. Cramping is common after IUD placement. You can use a heating pad, take a warm bath, or use other coping activities that work for you. If you have painful cramping that is not relieved by medicine and comfort measures, please call the clinic.

If comfort measures are not enough, taking an over-the-counter pain medicine may help.

Use these medicines only if recommended by your healthcare provider. Check with the healthcare provider first before taking any type of medicine. This handout includes brand names (like Tylenol, Aleve), but generic versions of the medicines work just as well and may be less expensive. Over-the-counter pain medicines:

• Acetaminophen (Tylenol): 500 mg every 6 hours
• Ibuprofen (Advil): 400 mg every 4 hours, or 600 mg every 6 hours
• Naproxen (Aleve): 220 mg every 12 hours

You may also switch (alternate) between taking ibuprofen and acetaminophen, or naproxen and acetaminophen:

• Ibuprofen 600 mg; 3 hours later acetaminophen 500 mg
• Naproxen 220 mg and acetaminophen 500 mg;
  6 hours later acetaminophen 500 mg alone

Bleeding is normal after an IUD is placed. It usually lasts a few days to a few weeks. Having the IUD placed may also cause you to start your period, so bleeding after placement is common.

Some people may have irregular bleeding or spotting for up to 6 months after the IUD is placed. If you are saturating 1 or more pads per hour for 2 hours, that is considered heavy bleeding and you will need to call the clinic.

• Your period will likely be shorter and lighter with a Mirena or Liletta IUD. About 40% of people will stop having periods with the Mirena or Liletta IUD. The Kyleena and Skyla have a lower amount of hormone, so fewer people stop their period.
• Your period may be heavier and longer with the Paragard IUD.
• Call the clinic if you are bleeding a lot and it is not getting better. 

• The IUD does not protect you against sexually transmitted infections including the AIDS virus (HIV), warts (HPV), gonorrhea, chlamydia and herpes.
• Condoms should be used to decrease the risk of getting a sexually transmitted infection.
• If you think that you have been exposed to a sexually transmitted infection, please call the clinic.

• Some IUDs are effective right away and can be used for emergency contraception.
• Other IUDs are effective right away if placed within 7 days after the start of your period; otherwise, they are effective 7 days after placement.
• If you have questions about when your IUD is effective, please ask your provider. If you are uncertain about when your IUD is effective, it is best to wait 1 week before relying on it for pregnancy prevention.

• Pregnancy is unlikely after the IUD is placed but can happen.
• If you have early pregnancy symptoms like nausea and vomiting, breast tenderness, frequent urination, or abdominal pain, you can take a pregnancy test.
• Please call the clinic if you have any concerns or if your pregnancy test is positive.

It is possible for the IUD to come out of the uterus. This is most likely to happen in the first few months after being put in. To make sure your IUD is in place, you can feel for the IUD strings. To check for strings:

• Wash your hands.
• Sit or squat down.
• Place one finger into your vagina until you feel your cervix. It will feel hard and rubbery, like the end of your nose. The string ends should be coming through your cervix.
• Do not pull on the strings.
• If the strings feel much longer than before, if you feel the hard plastic part of the IUD, or if you cannot feel the strings at all, the IUD may have moved.
• If the IUD has moved, please call the clinic and consider using a back-up form of birth control until you are seen.

Sometimes we recommend a follow-up visit 1 to 2 months after the IUD has been placed, but it is not always required.

• The IUD should only be removed by a healthcare provider.
• The Skyla IUD should be removed and/or replaced after 3 years.
• The Kyleena IUD should be removed and/or replace after 5 years.
• The Mirena or Liletta IUD should be removed and/or replaced after 8 years.
• The Paragard IUD should be removed and/or replaced after 10 years.

Call the clinic if you have any of these symptoms or concerns:

• You are saturating 1 or more pads per hour.
• You have fever or chills.
• The IUD comes out or you have concerns about its location.
• You have a positive pregnancy test or think you might be pregnant.
• You are having heavy vaginal discharge, especially if it has a bad odor or your vaginal area is very itchy.
• Your pain is not controlled with the medicines recommended.