Managing pain during IUD placement: How to advocate for yourself

As health care providers, one of the most common questions we hear from people considering an intrauterine device (IUD) is: “Will it hurt?” If you’ve heard stories about IUD placement being uncomfortable or painful, you’re not alone. For far too long, providers have downplayed how painful this procedure can be. The good news? We’re finally starting to catch up and recognize the importance of appropriate pain management to make the experience more comfortable. Whether you’re someone who dreads a pelvic exam or just wants to feel more prepared, here’s what you need to know about your options.

What to expect during placement

An IUD is a small, flexible T-shaped device placed inside the uterus by a health care provider. The process usually takes about 5 minutes and is typically done in a clinic or provider’s office setting. That said, it can involve cramping, sometimes mild, sometimes more intense, especially during the part when the device we use to measure the size of the uterus or the IUD passes through the cervix. Some people feel only mild pressure, while others describe intense cramping or pain. Everyone’s body is different. But pain is not something you have to simply “tough out.” You have options.

Pain management options

There’s no one-size-fits-all answer for comfort, but here are the some of the most commonly used strategies:

1. Numbing medication (local anesthetic)

Providers can inject a numbing medicine into the cervix (called a paracervical or intracervical block). It’s like what you’d get at the dentist, just in a different part of your body.

• Pros: For many people, it can significantly reduce pain during the actual insertion.
• Cons: Not all providers regularly offer this, and the injection itself can be a bit uncomfortable.

2. Over-the-counter pain medications

Taking naproxen sodium (Aleve) or ibuprofen (like Advil or Motrin) 30–60 minutes before your appointment can help reduce cramping, especially right after the IUD placement.

• Pros: Widely available, inexpensive, easy to use
• Cons: Less helpful for cramping and pain during the insertion itself

3. Anxiety or sedation support

For folks with medical anxiety, a history of trauma, or previous painful pelvic exams, anxiety-reducing medications like a low dose of lorazepam (Ativan) may be offered ahead of time. Some clinics also offer light sedation for IUD placement, but this is less common. In certain situations, people can request anesthesia where they are “fully asleep” for the procedure.

• Pros: Can be helpful for people who feel particularly nervous or anxious about the procedure
• Cons: Requires planning ahead and someone to drive you home

4. Supportive care: Music, deep breathing, distraction

Believe it or not, simple techniques—like deep breathing, listening to music, or having a trusted friend with you—can help your body, and specifically your pelvic floor muscles, stay less tense, which often means less pain. So, bring headphones or your best friend—we’re all for it.

• Pros: No cost, no side effects
• Cons: May not be enough on their own for more intense discomfort

Aftercare counts, too

Some cramping or spotting is normal after IUD placement. Ask for a work or school excuse note if you need it. Once you’re home, using a heating pad, taking over-the-counter pain relievers, and resting can help. The cramping usually improves after a few hours to a couple of days.

So, what’s right for you?

The best approach depends on your body, your preferences, and your health history. It’s completely okay to advocate for yourself and ask your provider what pain management strategies they offer, and to request something more than “just breathe through it” if you need something else.

Ask questions like:

• “Do you offer numbing medication for IUD placements?”
• “Can I take ibuprofen before my appointment?”
• “What if I’ve had a painful experience in the past?”

If a provider doesn’t offer the type of pain management you want, ask if someone else in their office does. Or ask about another clinic that does offer what you want. You deserve an experience that’s respectful and tailored to your needs.

Bottom line

Getting an IUD shouldn’t mean powering through pain. Talk to your provider, explore your options, and remember—pain management is not a luxury; it’s part of quality health care.