IUD Cramps Can Be Normal — Or Not

Updated 14 January 2021 |

Published 03 December 2019

Fact Checked

Reviewed by EBCOG, the European Board & College of Obstetrics and Gynaecology

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An intrauterine device, or IUD, can give you up to 12 years of protection from unintended pregnancy, with as much as 99% certainty. Unfortunately, IUD usage is also often associated with cramps.

So what causes IUD-related cramps, when can you expect them to cease, and how can you tell if your IUD cramps are normal or not? Let’s check it out together with the European Board and College of Obstetrics and Gynaecology (EBCOG).

Normal IUD cramps

IUD insertion pain: overview

It’s normal to feel some tolerable IUD insertion pain. It occurs when your doctor or nurse touches and dilates your cervix with special tools and pushes the IUD through the cervix into the uterus. Some people describe it as a bit harsher version of cramps you may feel during a pap smear.

The process of IUD insertion lasts only a few minutes, and cramps often become better in 15–20 minutes. To manage the pain, you can take over-the-counter pain relievers in advance, for example, ibuprofen. You can also ask your provider for a local anesthetic to numb the cervical canal before the procedure. 

Some professionals may use ultrasound guidance to show you the insertion. This may distract you from possible discomfort and help you feel in control of the procedure. Ask your doctor about their approach.

Women who have had a vaginal delivery usually feel less IUD insertion pain. For others, the insertion may be more painful. Some doctors prescribe a local treatment to soften the cervix, make insertion easier, and cause less discomfort. Please discuss this with your doctor.

You may experience dull or throbbing pain similar to menstrual cramps for a few days after your IUD was installed. And like menstrual cramps, IUD cramps can usually be managed with pain relievers or a heating pad. However, if your cramps suddenly became severe or you feel a sharp pain in the lower abdomen, it’s best to consult your health care provider immediately.

IUD cramps during the first months with it

Hormonal and copper IUDs affect menstruation differently. A hormonal IUD can ease your menstrual cramps and make your periods scantier. On the contrary, a copper IUD can cause increased menstrual cramping and heavier periods. These symptoms usually improve in 3–6 months.

If IUD cramps continue to bother you and pain relievers don’t help much, you may wish to consult your doctor. In rare cases, the symptoms can be severe enough to consider removing the IUD.

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Abnormal IUD cramps

If you feel really bad pain in your lower abdomen at any stage of IUD usage, you may need to see your doctor or nurse. Modern IUDs rarely cause complications, but it’s best to be on the safe side. Here are a few other warning symptoms to watch for:

• Lower abdominal pain that is not linked to your periods
• Pain or bleeding during sex
• Unexplainable fever
• Abnormal vaginal discharge
• Unusually heavy vaginal bleeding

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If you have any of these symptoms, it’s best to consult with your health care provider as soon as possible.

It’s also important to check the IUD strings from time to time. If you feel that they’ve become shorter or if you can feel the bottom of the IUD itself, it means that the IUD is out of place and you need medical attention. If your IUD is out of place, it may not provide protection from pregnancy, so you need to use a backup method of contraception.

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IUD cramps: bottom line

Cramps are a common side effect of IUD usage, especially copper IUDs. In most cases, IUD cramps can be managed with appropriate pain medication and stop after a while. In rare cases, you may feel unusually severe cramps with an IUD, which is a sign you need to consult with your doctor.

An IUD also has a number of advantages: 

• It’s one of the most effective contraceptive methods available today (99%). 
• IUDs have a very good safety profile. They pose no major health risks, including cardiovascular risks and risks of venous blood clots.
• It’s a long-lasting method that provides 3–7 (hormonal) or up to 12 (copper) years of protection from unplanned pregnancy.
• An IUD can be easily removed, after which you can get pregnant very soon.
• A hormonal IUD can actually help your period cramps and make your periods less heavy.

Content created in association with EBCOG, the European Board & College of Obstetrics and Gynaecology

History of updates

Current version (14 January 2021)

Reviewed by EBCOG, the European Board & College of Obstetrics and Gynaecology

Published (03 December 2019)