This FAQ is designed to help you understand what to expect before, during, and after IUD placement, including how we schedule visits to ensure safety, comfort, and informed consent.
What is an IUD?
What is an IUD?
An intrauterine device (IUD) is a small, T-shaped device placed in the uterus to prevent pregnancy. Hormonal IUDs such as Mirena, Liletta, Kyleena, and Skyla are highly effective, long-acting, and reversible forms of contraception.
How long does the Mirena IUD work?
How long does the Mirena IUD work?
The Mirena IUD protects against pregnancy for up to 8 years. If you are seeking an IUD to decrease bleeding and cramping, the hormone component of the IUD may run out after 5 years.
Does the IUD protect against sexually transmitted infections (STIs)?
Does the IUD protect against sexually transmitted infections (STIs)?
No. IUDs do not protect against STIs, including HIV, gonorrhea, chlamydia, syphilis, herpes, or HPV. Condoms (external or internal) or dental dams should be used if you are at risk for STIs.
What visits are required to get an IUD?
What visits are required to get an IUD?
We schedule IUD care intentionally to prioritize safety, informed consent, and comfort.
New patients
New patients
One 60-minute Establish Care visit
One 60-minute IUD Insertion visit
The establish care visit allows time to review your medical history, discuss contraception options, review risks and benefits, address pain-management preferences, and ensure appropriate screening before the procedure.
Established patients
Established patients
One 30-minute IUD consultation visit
One 60-minute IUD Insertion visit
What about IUD removal?
What about IUD removal?
IUD removals follow a similar structure, but the procedure time is shorter.
Consult visit: same as above (new or established patient)
Removal procedure: 30-minute visit
Will I need a pregnancy test?
Will I need a pregnancy test?
Yes. A pregnancy test is required before IUD insertion if you have vaginal receptive sex with one or more people who make sperm in the last 9 months.
If you had unprotected sex within the last 7 days, an early pregnancy may not yet show on testing, even if the result is negative.
When does my IUD start working?
When does my IUD start working?
Hormonal IUDs (Mirena, Liletta, Kyleena, Skyla) begin working after 7 days.
You should use backup contraception (such as condoms) during the first 7 days.
If you have unprotected sex during this time, emergency contraception is recommended.
What should I do the day of insertion?
What should I do the day of insertion?
You may return to work or school the same day. For 24 hours after insertion, please avoid:
Vaginal intercourse
Baths or swimming
Tampons or menstrual cups
What side effects are normal after insertion?
What side effects are normal after insertion?
It is common to experience:
Cramping
Spotting or irregular bleeding
Heavier or longer periods at first
These symptoms are most common in the first 3–6 months and typically improve over time. With Mirena and similar hormonal IUDs, many people experience lighter periods or no periods at all after 6–12 months. This is not harmful.
How can I manage cramping or bleeding?
How can I manage cramping or bleeding?
Ibuprofen is very effective for cramping and bleeding
Up to 800 mg every 8 hours with food
Heating pads or hot water bottles may also help
Can the IUD fall out?
Can the IUD fall out?
Yes, expulsion is uncommon but most likely within the first 3 months.
If the IUD comes out, pregnancy can happen immediately.
Use condoms if you think your IUD may have moved or fallen out
Contact us if you are unsure
How do I check my IUD strings?
How do I check my IUD strings?
You may gently insert a clean finger into the vagina to feel for the cervix (it feels like the tip of your nose). You should feel thin strings similar to fishing line. Strings may be tucked higher and can sometimes be difficult to feel — this can still be normal.
Will a tenaculum be used during my procedure?
Will a tenaculum be used during my procedure?
We will discuss the risks and benefits of using a tenaculum, a Carevix device, or no device to stabilize the cervix. Not using either a tenaculum or a Carevix may reduce discomfort for some patients but can slightly increase the risk of uterine perforation. This is a shared decision based on your preferences and anatomy.
Will my procedure hurt?
We offer many options to reduce pain. We offer the option to use a Carevix cervical stabilizer instead of a tenaculum or no device to stabilize the cervix. We offer pain and anxiety medication (oxycodone and lorazepam) when medically appropriate and you have a driver to and from the procedure. We also offer topical numbing in the form of lidocaine jelly to insert vaginally 1 hour prior to the procedure. We do not use stirrups for IUD insertions as you do not need to be restrained to get an IUD inserted.
While using a carevix device or no device is less painful than using a tenaculum, you may experience pain during the part of the procedure to measure the uterus or the actual IUD insertion. The combination of using the carevix device and taking pain medications significantly improve the patient experience. Scheduling your procedure during ovulation or menstruation can significantly reduce pain of insertion as well because the cervix is more open at this time of the cycle.
Many facilities offer IV sedation or general anesthesia for IUD insertion. We do not have the capacity at this time to offer those services. We can help facilitate referrals to facilities that offer IV sedation or anesthesia if desired.
Can I request a Carevix device for an IUD removal?
A cervical stabilizer is not necessary for an IUD removal, so you do not need either a tenaculum or a cervical stabilizer device. We do offer anxiety and pain medication if medically appropriate and you have a driver.
Do you offer IV sedation or anesthesia?
Unfortunately we do not have the required equipment and training to offer those services at this time.
Do I need a follow-up visit?
Do I need a follow-up visit?
Routine follow-up is recommended. We recommend a check-in at 4–6 weeks.
You do not need follow-up if you can feel your strings and feel well.
You may request an exam at any time.
When should I contact a provider urgently?
When should I contact a provider urgently?
Within the first 3 weeks after insertion
Within the first 3 weeks after insertion
Fever over 101°F
Chills
Severe or sharp abdominal pain
At any time
At any time
Foul-smelling vaginal discharge
Positive pregnancy test or pregnancy symptoms
Suspected STI exposure
Concern that the IUD has moved or fallen out
Final notes
Final notes
We believe IUD care should be unrushed, informed, and patient-centered. The required visit structure ensures we can provide trauma-informed care, thorough counseling, and adequate pain-management options.
If you have questions or want to schedule an IUD consult, please contact us.
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