I’m a big proponent of IUDs. The birth control option, formally known as an intrauterine device, lasts years (between three and 12, depending on the type) and it’s a “set it and forget it” solution. There are no daily pills to take, and aside from the occasional placement check by yourself or your doctor, it’s a pretty straightforward and extremely effective way to prevent pregnancy.
I’ve shouted from the rooftops about my love for my IUDs with one small caveat. The insertion process is, let’s just say, not pleasant. For a long time—over the course of 20 years and two IUDs, in my experience—I justified it with the thinking that just a couple of painful minutes would offer me years and years of pregnancy protection. I got the Paragard copper IUD in college, and the Kyleena, a hormonal IUD, in 2019 after having a baby. Both times, I brushed my physical discomfort aside as yet another “cost” of being a woman. That was, until I refused to put myself through the agonizing pain of insertion for a third time.
Instead, I decided to go under anesthesia—an option finally becoming more readily available to women who undergo the procedure—and I don’t regret it for one second.
What is an IUD, and how does it work?
“An IUD, or intrauterine device, is a small T-shaped device placed in the uterus by your physician,” explains Dr. Adrienne Stevenson, MD, a board-certified ob/gyn and Twentyeight Health care provider. “It’s one of the most effective forms of birth control, with over 99% effectiveness.”
There are two types available: hormonal and non-hormonal. “An IUD is used for long-term, reversible birth control, with copper (non-hormonal) and hormonal (progestin) options available,” adds Dr. Jennifer Peña, MD, Chief Medical Officer of Wisp. “Copper IUDs make the uterus inhospitable to sperm, while hormonal IUDs thicken cervical mucus, block sperm, and can sometimes prevent ovulation.”
Providers place an IUD by first introducing a speculum into the vagina. “The speculum allows us to see the cervix,” explains Dr. Stevenson. Then, the IUD is inserted via “a plastic sheath that compresses it, allowing it to pass through the cervix and into the uterus,” Dr. Stevenson says. The sheath comes out once the IUD is properly placed. Pain levels during the procedure can vary from person to person, but most people feel something when the IUD passes from the cervix into the uterus. Nerves inside the reproductive system can cause cramping similar to period cramps for some, while others might feel intense, sharp pain.
