Getting an IUD typically takes just two steps: a consultation with a healthcare provider and the insertion itself, which often happen in the same visit. The entire process, from walking into the clinic to walking out with an IUD in place, can take under 30 minutes. Here’s what to expect at every stage.
Choosing Between Copper and Hormonal
Five IUD brands are FDA-approved in the United States, and they fall into two categories. Paragard is the only copper IUD. It contains no hormones and protects against pregnancy for up to 12 years. The other four are hormonal IUDs that release a small amount of progestin: Mirena (up to 8 years), Liletta (up to 8 years), Kyleena (up to 5 years), and Skyla (up to 3 years).
Both types work by changing the way sperm move so they can’t reach an egg. Copper is naturally repellent to sperm, so Paragard creates an environment where sperm essentially can’t function. Hormonal IUDs take a two-pronged approach: they thicken the mucus on your cervix to trap sperm, and they sometimes prevent your ovaries from releasing an egg in the first place. All five IUDs are over 99% effective with both typical and perfect use, making them more reliable than the pill (91% with typical use), condoms (82%), or the injection (94%).
The biggest practical difference between the two types is how they affect your period. Hormonal IUDs tend to make periods lighter over time, and some people stop getting periods altogether. The copper IUD can make periods heavier and crampier, especially in the first few months. Your provider will help you weigh these tradeoffs based on your health history and preferences.
Booking Your Appointment
You can get an IUD from an OB-GYN, a primary care provider, a Planned Parenthood clinic, or a Title X family planning clinic. Title X clinics specifically serve people who are uninsured or underinsured, and you can find one near you through the federal clinic locator at reproductivehealthservices.gov.
Under the Affordable Care Act, most health insurance plans must cover FDA-approved contraceptive methods, including IUDs, with no copay, coinsurance, or deductible when you use an in-network provider. The main exceptions are plans sponsored by certain religious employers. If you’re uninsured, the out-of-pocket cost for an IUD can run several hundred dollars, but Title X clinics and Planned Parenthood offer sliding-scale fees.
When you schedule, the office may ask for your insurance information ahead of time to get pre-approval for the device. Some clinics also send educational materials before your visit so you can come in with questions ready.
What Happens at the Consultation
Your provider will explain the risks and benefits of each IUD type, walk you through what to expect with your period after insertion, and answer your questions. This counseling can happen during the same visit as the insertion or at a separate appointment beforehand.
Testing requirements are minimal. A pregnancy test is only needed if there’s any uncertainty about whether you could be pregnant. If you’re under 25 or have multiple sexual partners, your provider will likely screen for gonorrhea and chlamydia, but that swab can be collected right at the time of insertion rather than at a separate visit. Routine STI screening isn’t recommended for people at low risk. You don’t need a Pap smear to get an IUD.
Preparing for Insertion Day
There’s not much you need to do, but a little preparation can make a real difference in comfort. Many clinics advise taking ibuprofen before your visit to help with cramping. Ask your provider’s office when you schedule whether they recommend this and what timing works best.
You can get an IUD at any point in your menstrual cycle. Some providers prefer to insert during your period because the cervix is naturally slightly more open, but this isn’t a requirement. Eat a snack beforehand and stay hydrated. Some people feel lightheaded during or after the procedure, so arriving on an empty stomach isn’t ideal.
What the Insertion Feels Like
The actual insertion takes only a few minutes. You’ll lie on an exam table in the same position as a regular pelvic exam. Your provider uses a speculum to see your cervix, then cleans the area with an antiseptic solution. A small instrument called a uterine sound measures the depth of your uterus, and then the IUD is placed through your cervix into your uterus using a thin insertion tube.
The most common sensation is a strong cramp when the device passes through the cervix. Some people describe it as a sharp pinch that lasts a few seconds, while others find it more intensely painful. Pain varies widely from person to person. Local anesthetic (a numbing injection near the cervix) can reduce insertion pain and is considered more effective than oral pain relievers alone. If you’re concerned about pain, ask your provider ahead of time whether they offer a cervical numbing block. Not all clinics offer this routinely, but it’s reasonable to request it.
Once the IUD is in place, the provider trims the thin strings attached to it so they hang just inside your cervix. These strings are how you (and your provider) confirm the IUD is still positioned correctly.
Recovery in the First Few Days
Cramping and spotting are normal immediately after insertion and can last for a few days. Most people feel well enough to go back to their regular activities the same day, though some prefer to take it easy for the rest of the afternoon. A heating pad and over-the-counter pain relievers help with cramps.
You can use tampons and have sex as soon as you feel comfortable, though your provider may suggest waiting 24 to 48 hours. Depending on where you are in your cycle and which IUD you chose, you may need to use backup contraception (like condoms) for the first seven days.
The Adjustment Period
Your body needs a few months to fully adjust to the IUD. During this time, irregular bleeding and spotting are common, especially with hormonal IUDs. This typically improves after about three months. Other side effects of hormonal IUDs can include headaches, acne, breast tenderness, mood changes, and pelvic cramping. These also tend to settle down as your body adjusts.
With the copper IUD, periods may be heavier and cramps stronger for the first three to six months. This is the most common reason people have a copper IUD removed early, so it’s worth factoring into your decision if you already have heavy or painful periods.
About a month after insertion, your provider will likely schedule a follow-up pelvic exam to make sure the IUD hasn’t shifted and to check for any signs of infection.
Checking Your IUD Strings
After each period, it’s a good idea to check that your IUD is still in place by feeling for the strings. Wash your hands, insert a finger into your vagina, and feel for thin threads near your cervix. You should be able to feel the tips of the strings but not the hard plastic of the IUD itself.
Contact your provider if you can’t feel the strings, if the strings seem longer or shorter than before, or if you can feel the hard base of the IUD. These could be signs the device has shifted. Your partner may also notice the strings during sex. If they’re bothersome, your provider can trim them shorter.
Who Can and Can’t Get an IUD
Most people can safely use an IUD, including teenagers and people who have never been pregnant. The CDC uses a four-tier system to classify who’s eligible for each type of contraception. For most healthy people, IUDs fall into the safest category with no restrictions.
Situations where an IUD may not be appropriate include active pelvic infections, certain uterine abnormalities, unexplained vaginal bleeding, or (for the copper IUD specifically) a copper allergy or Wilson’s disease. For hormonal IUDs, current breast cancer is a contraindication. Your provider will screen for these during your consultation. Having a history of ectopic pregnancy, being on blood thinners, or having a tilted uterus does not disqualify you from getting an IUD.