For the first 24 hours after IUD insertion, you should avoid vaginal sex, tampons, baths, and strenuous exercise. Beyond that first day, there are a few additional precautions worth knowing about to help your body adjust, reduce cramping, and lower the small risk of infection or the device shifting out of place.
The First 24 Hours
The most important window is the day of your insertion. During this time, avoid putting anything into your vagina. That means no tampons, no vaginal sex, and no baths or swimming. Your cervix was just opened slightly to place the device, and it needs time to close back up. Introducing bacteria during this window raises your infection risk.
You should also plan to take it easy physically. While there’s no strong evidence that exercise will actually dislodge your IUD, rest helps manage the cramping and bleeding that most people experience right after insertion. Light walking is fine if you feel up to it, but skip the gym for the day.
Exercise and Heavy Lifting
After 24 hours, most people can return to their normal exercise routine. Your movement won’t move the device. Even running a marathon right after insertion wouldn’t significantly increase the risk of the IUD shifting or falling out.
That said, your body may not feel ready for intense workouts right away. Strenuous exercise and heavy weights can worsen cramping and bleeding, especially if you’re dehydrated. For the first few days, light cardio, yoga, or weight training with lighter loads tends to feel better and can actually help ease discomfort. Let your symptoms guide you. If cramping picks up during a workout, dial it back.
Managing Pain the Right Way
Cramping after insertion is normal and can range from mild to fairly intense for the first two to three days. Ibuprofen at 400 to 600 mg every four to six hours, taken with food, is the standard recommendation. It works well because it targets both pain and the inflammation causing the cramps. Most people feel significantly better by day two or three.
If you’re unable to take ibuprofen, acetaminophen is an alternative, though it won’t reduce inflammation the same way. A heating pad on your lower belly can also help. What you want to avoid is pushing through severe pain without addressing it, since worsening pain that doesn’t respond to over-the-counter medication can be a sign something isn’t right.
Don’t Pull on Your IUD Strings
Your IUD has thin strings that hang down through your cervix into the upper part of your vaginal canal. These are there so you (and your provider) can confirm the device is still in place. What you should never do is tug on the strings or try to adjust the IUD yourself. Pulling on the strings can partially dislodge the device, turning a non-issue into a problem.
If the IUD falls out on its own, do not try to reinsert it. Contact your provider instead.
When and How to Check Your Strings
For the first three months after insertion, check your strings every four weeks. The easiest time is right after your period ends, when your cervix sits slightly lower and the strings are easier to reach. After those first three months, checking every few months is enough. You’re feeling for the tips of the strings at the top of your vaginal canal. They should feel roughly the same length each time. If they suddenly feel longer, shorter, or you can’t find them at all, that’s worth a call to your provider.
Signs Your IUD May Have Shifted
IUDs are most likely to move out of place within the first three months, and strong uterine cramps are the most common cause. Periods of heavy bleeding also increase the chance slightly. Signs that something has shifted include:
- Sharp or sudden cramping that feels different from your normal post-insertion discomfort
- Unusual bleeding patterns, such as unexpected heavy bleeding with a hormonal IUD or unusually light periods with a copper IUD
- Strings that feel different in length, or the hard plastic tip of the device becoming noticeable in your vaginal canal
- Pain during vaginal penetration that wasn’t there before
- Unusual vaginal discharge
A displaced IUD can’t protect you from pregnancy reliably, so if you notice these signs, use a backup method of contraception until you’ve been checked.
Warning Signs That Need Prompt Attention
Some discomfort after insertion is expected, but certain symptoms signal a possible complication like infection or perforation. Contact your provider promptly if you experience:
- Lower abdominal pain that doesn’t improve with ibuprofen or other painkillers
- Sudden, worsening pelvic pain that comes on sharp and doesn’t go away
- Fever
- Foul-smelling vaginal discharge
These symptoms don’t necessarily mean something is seriously wrong, but they do need to be evaluated rather than waited out.
Follow-Up Appointments
The CDC does not require a routine follow-up visit after IUD insertion, though some providers will schedule one anyway to check that the strings are visible and the device is in place. If your provider doesn’t schedule a follow-up, that’s normal. You can always call if you have concerns about side effects, new symptoms, or if you want to discuss switching methods. The key ongoing task is your own string checks, especially during those first three months when displacement is most likely.