Preparing for an IUD insertion is mostly straightforward: there’s no lengthy prep required, but a few steps beforehand can make the experience more comfortable. The procedure itself takes about five minutes, and most of the preparation happens in the days and hours leading up to your appointment.
You Can Schedule It Any Time in Your Cycle
A common belief is that you need to have your IUD placed during your period. Some providers prefer this timing because menstruation offers reassurance that you’re not pregnant, and the cervix may be slightly more open. But a CDC systematic review found that the timing of insertion during the menstrual cycle has little effect on pain, bleeding, expulsion rates, or long-term effectiveness. Outcomes were no better when insertions happened during menstruation compared to any other point in the cycle.
So if scheduling during your period is inconvenient, don’t worry about it. Your provider can confirm you’re not pregnant through other means, and the procedure works just as well on any day.
Managing Pain Before the Procedure
Taking an over-the-counter anti-inflammatory pain reliever before your appointment is one of the simplest things you can do. Ibuprofen (such as Advil or Motrin) or naproxen (Aleve) are the most commonly recommended options. Current clinical guidance from the American College of Obstetricians and Gynecologists supports offering these medications before the procedure. Some research has explored whether starting ibuprofen the day before, taking 800 mg doses over the 24 hours leading up to insertion, provides more pain relief than a single dose. While the evidence is mixed on exactly how much it helps, taking a standard dose about 30 to 60 minutes before your appointment is a reasonable step.
If you experience significant anxiety about the procedure, it’s worth mentioning this to your provider ahead of time. Some clinics can prescribe a mild anti-anxiety medication to take before the appointment, which current best-practice guidelines support as an option for patients who need it.
Ask About Numbing Options
Pain management during IUD insertion has improved in recent years, and you have more options than you might realize. Ask your provider’s office what they offer when you book the appointment, so there are no surprises.
The main options include topical numbing creams or sprays applied to the cervix, and local anesthetic injections (similar to what a dentist uses). A numbing cream containing lidocaine and prilocaine applied to the cervix has been shown in a systematic review to be the most effective topical option for reducing pain during placement, though it requires about a seven-minute wait to take effect. Lidocaine spray applied to the cervix is another option. Local anesthetic injections into or around the cervix provide stronger numbing but involve brief discomfort from the injection itself.
Not every clinic routinely offers these, so asking in advance lets you plan. If your provider doesn’t typically use numbing, you can request it.
What Screenings to Expect
You generally don’t need a long list of tests before getting an IUD. According to CDC guidelines, most patients don’t require additional STI screening at the time of placement. If you have risk factors for sexually transmitted infections and haven’t been recently screened for gonorrhea and chlamydia, your provider may test you at the appointment itself, and placement doesn’t need to be delayed while waiting for results. The one situation where insertion should not happen is if you have a current active infection with gonorrhea, chlamydia, or visible signs of cervical infection.
Pregnancy testing is not classified as a mandatory prerequisite either. Your provider will likely ask about your last period and sexual activity to rule out pregnancy, but a formal test isn’t always required.
Skip the Cervical Softening Medication
You may have heard of misoprostol, a medication sometimes prescribed to soften and open the cervix before insertion. Current guidelines from both the CDC and ACOG recommend against its routine use. Multiple studies have found that it doesn’t meaningfully reduce pain or make insertion easier for providers, and it frequently causes uncomfortable side effects like abdominal cramping, diarrhea, and low-grade fever in the hours before the appointment. It may actually increase your overall pain experience rather than decrease it.
The exception is if you’ve had a previous failed insertion attempt. In that specific situation, misoprostol given vaginally in the hours before a second attempt has shown some benefit in improving placement success. But for a first-time insertion, it’s not worth the side effects.
What to Bring and Wear
The practical side of preparation is simple. Wear comfortable clothing that’s easy to change out of from the waist down. Bring a panty liner or light pad, since some spotting after insertion is normal. Eat a light meal or snack beforehand, as arriving on an empty stomach can make you feel lightheaded if you experience a drop in blood pressure during the procedure (this is uncommon but possible).
If you’re someone who finds medical procedures stressful, consider bringing headphones and a playlist or podcast. Some people find that having a distraction during the few minutes of insertion makes a noticeable difference. Bringing a friend or partner for support is another option worth considering.
What to Expect Right After
The insertion itself typically takes under five minutes. You’ll likely experience cramping during the procedure that ranges from mild to intense but is short-lived. Afterward, you may feel crampy and slightly lightheaded for a few minutes. Most clinics will have you rest briefly before leaving.
Plan to take it easy for the rest of the day. Cramping similar to period pain is common for the first few hours and can come and go for several days. Having your pain reliever of choice and a heating pad at home makes the rest of the day much more comfortable. Avoid strenuous exercise for the first 24 hours, and hold off on using tampons or having sex for at least 24 to 48 hours to give your cervix time to close.
Your provider will likely schedule a follow-up visit four to six weeks after placement to check that the IUD is positioned correctly. In the meantime, you can check the IUD strings yourself by reaching toward your cervix with clean fingers. Your provider will show you how at the appointment.