One of the many birth control options available to women today is the intrauterine device (IUD), which is available in both hormonal and non-hormonal varieties. When placed inside the uterus, an IUD can prevent pregnancy for up to 10 years, depending on the type. As with any other medical device, IUD side effects are possible, the frequency of which varies by type. One of the most common side effects is IUD pain, which includes pain during or immediately after insertion only as well more intense menstrual cramps, or dysmenorrhea. In general, nearly all women will experience IUD pain during the insertion and for a variable period of time afterward, and anywhere from four to 15 percent of women may experience ongoing dysmenorrhea that warrants IUD removal.
IUD pain during insertion is typically mild. Many doctors advise their patients to take an over-the-counter pain medication such as ibuprofen 30 minutes before the procedure, in order to minimize this pain. Other methods of controlling IUD pain during insertion include local anesthetic injections and scheduling insertion during the menstrual period, when the cervix is slightly open. In the case of a very tightly closed cervix, it may be necessary to apply medications to soften the cervix prior to insertion, making the process both easier for the physician and less painful for the patient.
After insertion, the body must adjust to having an IUD in place. During this time, patients typically experience dull pain similar to menstrual cramps. In most patients, this IUD pain only lasts a few days and is easily treated with ibuprofen. Some women may have this pain for up to six months. Women should tell their doctors about any severe cramping they experience while not menstruating, as well as any IUD pain accompanied by other symptoms such as unusual vaginal discharge, chills, or nausea. These symptoms may not be signs of a simple IUD side effect, but may indicate the presence of an infection.
Women may also have an increase in menstrual cramps after getting an IUD. In patients with hormonal IUDs, this increase in pain is generally temporary, with many women experiencing a decrease in both menstrual pain and flow after approximately three months. Non-hormonal IUDs may cause an ongoing increase in menstrual cramps, even if the patient never had painful periods before. Painful menstruation caused by IUD use is known as secondary dysmenorrhea. In up to 15 percent of cases, this IUD pain is so severe that the patient elects to have the device removed.
