Key Takeaways
- IUD replacement typically involves a quick removal and insertion process, usually taking only a few minutes, and is often reported to be less painful than the initial IUD insertion.
- To prepare for IUD replacement, consider taking an over-the-counter pain reliever beforehand, and discuss any anxiety with your doctor, who may prescribe medication to help you relax.
- After IUD replacement, you can resume sexual activity as soon as you feel comfortable, but using a backup birth control method for the first month is advisable to prevent unplanned pregnancy and reduce the risk of infection.
If your pending intrauterine device (IUD) replacement has you filled with dread, take a deep breath and try to relax. Chances are it won’t be as uncomfortable as your first IUD insertion.
Ready to learn more? We’re answering all your IUD replacement Qs here.
That depends on the IUD you have and your reason for removing it.
You can remove an IUD at any time, but if you want it replaced — and don’t want to get pregnant — removing it before it expires might help you avoid needing a pregnancy test at your replacement appointment. (We’ll elaborate on that in a minute.)
Here’s the replacement time for the various IUD brands:
Your appointment will begin with questions about your medical history and the signing of a consent form. This is also your chance to ask any questions you have about the procedure or recovery.
Alternatively, you might have an initial appointment at which you review the risks and benefits of an IUD and then come back later for the insertion.
At the insertion appointment, you might receive pain medication to help with cramping if you haven’t already taken some. You might also be asked to bring your own medication.
The following is a rundown of the other things you can expect on IUD replacement day:
Pregnancy test
Your appointment may or may not begin with a pregnancy test, said Alyssa Dweck, MD, OB-GYN, author of “The Complete A to Z for Your V” and sexual health expert for INTIMINA.
“A few caveats: Any abnormal bleeding at the time of replacement does warrant a pregnancy test,” Dweck added. “Also, if one is using a hormonal IUD for cycle control (e.g., heavy bleeding) and isn’t sexually active, technically a test isn’t needed.”
Pelvic exam
The doctor will perform a pelvic exam to check the position of your uterus and feel around for pain or other abnormalities.
Speculum placement
The doctor will insert a lubricated speculum into your vagina. The speculum is the instrument that is used to open up your vaginal walls when you get a Pap test.
IUD removal
Your doctor will use ring forceps to grasp the IUD strings and gently pull the IUD out. This usually causes the arms of the IUD to collapse upward so that it slides out easily.
Measurement and IUD insertion
Once the IUD is out, the doctor will insert a thin device called a uterine sound (basically a ruler for your V) into your vagina to measure the length of your uterine cavity and cervical canal.
They will then remove the IUD from its sterile packaging, bend its arms back, and use a tube or slider to insert it through your vaginal canal and cervix into your uterus to the depth indicated by the sound.
Potential ultrasound
A quick ultrasound is sometimes performed after IUD insertion to check the placement of your new IUD.
“In routine instances, it shouldn’t take longer than a few minutes,” said Dweck.
Removal and insertion are literally in-and-out — er, out-and-in — procedures that typically take up to 5 minutes each.
Most experts and people who have had an IUD replacement say that it’s not as painful as when you first get an IUD. Dweck agreed.
“Anecdotally, this is true in my professional experience, although I’m not sure if it’s ever been studied clinically,” Dweck said. “This makes sense since in part because the anticipation of a horrendous insertion experience is no longer present and in part because the cervix and uterus have already been manipulated.”
You shouldn’t feel anything other than some slight cramping after IUD removal.
Dweck recommends taking an over-the-counter pain reliever, such as acetaminophen or ibuprofen, 30 minutes before your appointment to minimize discomfort.
You can also ask your doctor to prescribe anti-anxiety medication, which Dweck does “in rare cases,” and ensure that you have someone to drive you home after the procedure.
The most common IUD side effects tend to be temporary, lasting only 3 to 6 months, and go away once your body gets used to the IUD and hormones — if you’re using a hormonal IUD, that is.
Common IUD side effects include:
- cramping
- low back pain
- spotting
- irregular periods
There are also some rare risks to be aware of:
- Infection: There’s a small risk of infection after insertion of an IUD.
- Expulsion: Your IUD should not shoot out of your body involuntarily, but it could shift out of place.
- Perforation: This occurs when the IUD becomes embedded in the wall of your uterus. The risk of perforation during insertion is very low.
Here are some other steps you can take to prepare for the best possible experience:
- Book your appointment for when you’re on your period. This might make insertion easier and less painful because your cervix is already dilated.
- Bring a bottle of water and snacks with you to help you perk up after the procedure.
- Have supplies ready for your recovery, such as liners or period underwear, pain meds, and a heating pad.
- If you can, arrange to have a day or two off from work or school so you can take it easy as you ride out any post-procedure cramping.
You should be able to have P-in-V sex as soon as you want after IUD replacement.
If the idea of penetration while you’re all crampy and spotting makes you cringe, there are plenty of other ways to get your sex on. Think mutual masturbation, solo play, dry humping, and erogenous play, just to name a few.
Using a backup method of birth control is a good idea if you decide to have P-in-V sex after IUD replacement. Using a barrier for the first month afterward may help reduce your risk of infection too.
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You’ll likely have a follow-up appointment 6 to 8 weeks after your IUD replacement to check that the strings are in place and don’t need to be trimmed further.
If you’re having any symptoms or if the IUD is causing you or your partner(s) any discomfort during P-in-V sex, this is the time to bring it up.
IUD replacement isn’t all cotton candy and rainbows, but there’s a good chance it won’t be nearly as bad as you’re thinking.
The actual removal and insertion take mere minutes, so any discomfort should be over before you know it.
If the idea of pain or your anxiety is getting the better of you, a doctor may be able to prescribe something to take the edge off.
Adrienne Santos-Longhurst is a Canada-based freelance writer and author who has written extensively on all things health and lifestyle for more than a decade. When she’s not holed-up in her writing shed researching an article or off interviewing health professionals, she can be found frolicking around her beach town with husband and dogs in tow or splashing about the lake trying to master the stand-up paddle board.