Painful Sex After IUD Insertion

IUDs are one of the most effective forms of birth control and can be inserted at your doctor’s office or at a health clinic. They are very safe and can protect you from pregnancy for three to ten years.

However, sex with an IUD can be uncomfortable for some people. Fortunately, the pain should go away after a few months.

Causes

The insertion of an IUD isn’t comfortable or painless for everyone. But most women who have one say the cramping and discomfort goes away quickly. If it doesn’t, your doctor will examine the area to see if your IUD has moved or was not inserted correctly.

A rare but serious problem is IUD perforation, which occurs when your device pokes through the wall of your uterus and gets stuck in a fat deposit or in your pelvic cavity. You might need abdominal surgery to have it removed.

IUDs are small T-shaped devices your local medical provider can insert into your uterus to prevent pregnancy and regulate your menstrual cycle. Copper IUDs block sperm from entering the uterus, and hormonal IUDs release progestin to thin the lining of your uterus, making fertilization more difficult.

IUDs are so safe and effective that many OB-GYNs recommend them to their patients. They are also cheaper than birth control pills or condoms. But some women have reported that sex while they have an IUD is painful or uncomfortable, especially if the IUD is in the lower part of the uterus. In most cases, your doctor will be able to tell you what’s causing the pain and offer suggestions for treatment. For example, a lack of foreplay and poor lubrication can cause cramping, which may ease with more arousal and the use of a good quality lubricant.

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Symptoms

IUDs are incredibly effective birth control, but pain during sex can be an issue. Often, it’s a sign that the IUD has shifted. But there are other reasons it could happen. “If it persists over 3 months, you should see a doctor for a pelvic exam,” says GYN and team lead at Zoom+Care Cynthia McNally.

An IUD is a small plastic device that can prevent pregnancy for up to ten years. It’s inserted during an office visit, in a process that’s similar to getting a shot. A gynecologist inserts a speculum into the vagina, then folds and places the IUD in the uterus. The cervix must open slightly for this, which can cause cramps that are similar to those during menstruation.

Many doctors offer premedication with ibuprofen or naproxen before the procedure, to help reduce discomfort. They also might inject numbing medication around the cervix. And they use gentle manipulation to minimize the pain as much as possible.

But some patients feel their gynecologists don’t take their pain seriously. When Valerie Johnson complained of pain and cramps after her IUD insertion, she said her doctor told her that some discomfort was normal. McNally tells patients that over-the-counter acetaminophen and ibuprofen, taken in the right doses, can help ease IUD-related cramping. Some women also try using a heating pad. None of these options have been proven to significantly reduce IUD insertion pain, though.

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Treatment

Many women feel like they’re being ignored by their OB/GYNs when they bring up pain or cramping after having an IUD. Some describe being told that the pain is “normal” or that sex will hurt even without an IUD. This can cause stress, and a recent study found that it is also linked to an increased risk of depression in women who use hormonal birth control.

A woman with an IUD should visit her doctor to have it checked every 3-6 months, especially if she’s experiencing cramping. In most cases, doctors can check the IUD just by feeling around inside her vagina. The doctor can also check the strings that hold the IUD in place for signs of a misplaced or moving IUD, and can correct the problem if necessary.

Having an IUD inserted can be painful, but the discomfort should only last a few minutes. Some gynecologists recommend taking over-the-counter pain medications such as acetaminophen and ibuprofen before the appointment to help reduce discomfort.

Some women may need a more thorough exam to make sure their IUD is in the right spot, but this doesn’t usually involve any additional pain. A doctor will examine the uterus and cervical canal with a speculum, and may use a stethoscope to listen for the sound of the IUD as it moves inside the uterus.

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Prevention

A doctor or nurse will insert an IUD into the top of your vagina or your cervix, and you’ll likely feel some cramping when it happens. However, pain doesn’t usually last long. If it does, it could be a sign that your IUD isn’t in the right place or that you have an injury in your uterus from the procedure. If it lasts a few months, or you have other symptoms such as heavy bleeding or foul-smelling discharge, make an appointment with your gynecologist.

Once a healthcare professional puts in your IUD, it’s safe to engage in sexual activity. You can also use lubricant to decrease discomfort. Over-the-counter acetaminophen and ibuprofen can help with the pain, too.

It’s rare for an IUD to fall out of your uterus, but it can happen. If it does, you’re at risk for pregnancy, which raises your risk of ectopic pregnancy, which occurs when the fertilized egg implants outside your uterus.

You can prevent IUD expulsion by having sex in a clean, sanitary environment and using lubrication. You can also avoid sex positions that cause deep or penetrative penetration.

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