There’s no long list of restrictions before getting an IUD, but a few things can make the experience smoother or avoid complications. Most of what matters comes down to pain management, timing, and skipping things that seem helpful but aren’t.
Don’t Skip Pain Relief (or Take It Too Late)
One of the most common mistakes is either forgetting to take a pain reliever beforehand or taking it right before you walk into the office. The current recommendation is 800 mg of ibuprofen taken one hour before the procedure. That timing matters because the medication needs to reach effective levels in your bloodstream before insertion begins. Taking it in the car on the way there won’t do much.
Naproxen sodium (550 mg) is an alternative, though it works a bit differently. In studies, it significantly reduced pain after insertion but didn’t help much with the discomfort during the procedure itself. If you can take ibuprofen, that’s the better choice for covering the whole experience. If you can’t take either because of allergies or stomach issues, let your provider know ahead of time so they can discuss other options like a local numbing agent.
Don’t Take Misoprostol to “Prep” Your Cervix
You may have read online that taking misoprostol (a medication that softens the cervix) before insertion makes the process easier. The CDC’s 2024 guidelines specifically recommend against this for routine IUD placement. Across 14 randomized controlled trials, misoprostol didn’t reduce pain, didn’t improve the provider’s ability to place the device, and didn’t increase the success rate of insertion. What it did do was increase cramping, abdominal pain, and diarrhea before the appointment even started.
The only situation where misoprostol has shown a benefit is after a previous failed insertion attempt, where it may improve the chances of success on a second try. If no one has attempted to place your IUD yet, this medication will likely just make you feel worse for no gain.
Don’t Assume You Need to Be on Your Period
A persistent belief is that you need to schedule your IUD insertion during your period. Some providers prefer it because menstruation offers reassurance that you’re not pregnant, and the cervix may be slightly more open. But the evidence doesn’t support waiting for your period as a medical necessity.
A systematic review looking at IUD insertions across different points in the menstrual cycle found that timing had little effect on continuation rates, expulsion rates, removal rates, or pregnancy rates over 12 months. Pain and bleeding at insertion were also similar regardless of cycle day. One large study of over 2,500 women found continuation rates were comparable whether insertion happened on cycle days 1 through 3 or days 15 through 21. Delaying your appointment to line up with your period may just mean unnecessary inconvenience, especially if your cycle is unpredictable.
Don’t Worry Too Much About Recent Sex
If you’ve had unprotected sex in the days before your appointment, you might wonder whether you need to reschedule. A study published in Obstetrics & Gynecology found that pregnancy risk after IUD placement remained low regardless of the timing or frequency of unprotected intercourse in the prior 14 days, as long as a pregnancy test was negative. No pregnancies occurred among participants who had unprotected sex 6 to 14 days before placement. The takeaway: a negative pregnancy test at the time of your visit is what matters, not abstinence beforehand.
That said, your provider will likely run a urine pregnancy test on the day of insertion. This is standard practice. If there’s any chance you could be very newly pregnant (within the first week or two after conception), urine tests can occasionally miss it because hormone levels haven’t risen enough to detect. Being honest with your provider about your recent sexual activity helps them make the right call.
Don’t Skip STI Screening if You Have Risk Factors
You don’t need a full panel of tests before getting an IUD. The CDC notes that most patients don’t require additional STI screening at the time of placement. However, if you have risk factors for sexually transmitted infections and haven’t been recently screened for chlamydia and gonorrhea, your provider should test you. Placement can still happen the same day while awaiting results, so screening alone isn’t a reason to delay.
The one firm rule: if you have a current chlamydia or gonorrhea infection, or visible signs of cervical infection, the IUD should not be placed until that’s treated. Inserting a device through an actively infected cervix raises the risk of pelvic inflammatory disease. If you suspect you might have an untreated infection, getting tested before your appointment saves you from a potential cancellation.
Don’t Forget to Plan for the Appointment Itself
The actual IUD placement takes less than 5 minutes in most cases. But the full appointment, including a urine sample, health history review, and the procedure itself, typically runs about 30 minutes. If you’re receiving any sedation, expect to be at the office or hospital for significantly longer, potentially 3 to 4 hours including prep and recovery time.
A few practical things to avoid: don’t schedule a packed day around the appointment. Many people feel crampy or tired afterward and appreciate having a lighter schedule. Don’t arrive on an empty stomach if you’re taking 800 mg of ibuprofen, since high-dose anti-inflammatories can cause nausea without food. And don’t drive yourself if you’re receiving any form of sedation or anti-anxiety medication for the procedure.
Wearing comfortable, easy-to-remove clothing and eating a small meal beforehand are simple steps that tend to make the whole experience less stressful. Bringing a pad is also a good idea, since light spotting afterward is common.