How Is an IUD Inserted?

An intrauterine device is not inserted by cutting or piercing. It is advanced through the cervical canal into the uterine cavity. This page explains, as practiced at our Şişli Fulya clinic, how the procedure actually goes, where the pain comes from, and when anesthesia is discussed. The diagnosis and choice of method are decided during the examination.

First, a short definition — matching the site's IUD page

Intrauterine devices (IUDs) are flexible devices, usually polyethylene-based, placed in the uterine cavity to prevent pregnancy; they are not expected to damage the body like a foreign object. Their shape is manufactured to fit the uterine cavity. Modern IUDs came into widespread use in the 1960s; their shape and composition have changed over time. Today they remain a long-acting, effective method of birth control.

Older population surveys showed a high rate of use in Turkey (19.8% of women in the 1998 survey; around 23% among married women in 2005). These figures are historical; today's rate varies by region and age group. The number does not mean the method is "right for everyone."

In the early 2000s, three main groups were discussed on the market. Today the range has diversified:

• Inert (unmedicated) IUDs
• Copper IUDs
• Silver IUDs
• Gold IUDs
• Platinum IUDs
• Hormonal IUDs

Which type is chosen depends on uterine size, menstrual pattern, breastfeeding, past infections, and the woman's preference. There is no single "best" option. The size and model remain the physician's decision, based on examination and, if needed, ultrasound.

Is there any piercing or cutting when the IUD is inserted?

No. The cervix is the canal that sits between the uterine cavity and the vagina. The IUD is advanced through this canal, folded inside the manufacturer's inserter tube, and opens in the cavity. The skin is not cut. The abdominal wall is not opened. No stitches are placed. The procedure is not described as a surgical incision.

The absence of a cut does not mean there is no sensation at all. The cervix may respond to touch with cramping. This cramp is not tearing; it is a brief stretching of the canal. These are two separate statements: the method is not a cut, and the sensation is not zero.

The difference between women who have and haven't given birth

In a woman who has given birth (especially vaginally), the cervix is a canal that has already opened before. The inserter's passage takes less time in most cases, and the cramp is described as shorter. This does not mean "no pain"; it means it statistically tends to go more easily.

An IUD can be placed in a woman who has never given birth. It is not prohibited. The cervix is narrower, the canal is less flexible. The inserter does the same job; the duration and sensation may increase. The sentence "an IUD cannot be placed in someone who hasn't given birth" is not a rule at this clinic. What is not the case is the same expectation: the procedure in a nulliparous patient's file may not go as quietly as in a parous patient's file.

A cesarean birth is not the same cervical history as a vaginal birth. The abdominal wall was opened; the canal is not considered to have opened to the same degree with every cesarean. So the statement "I gave birth, so it's easy" is not sufficient on its own. How the birth occurred is asked.

Size and fit — the doctor chooses

There is no single body size for an IUD. The length and width of the uterine cavity vary from woman to woman. A large frame does not sit well in a short or narrow cavity; displacement, cramping, and increased bleeding are then discussed. Conversely, too small a device in a wide cavity can raise the risk of unwanted pregnancy.

Sizing is assessed with a speculum and, if needed, transvaginal ultrasound. The doctor chooses the length appropriate for the cavity. A patient's request for "something small so it hurts less" does not substitute for sizing. The wrong size doesn't just affect that day's sensation — it disrupts the following months.

Does IUD insertion hurt?

What it causes in most cases is a brief pressure similar to menstrual cramps. Some women describe it as "I just felt touched"; others describe a cramp spreading down from the lower back for a few minutes. Both can occur during the same procedure. Pain threshold, cervical dilation, anxiety, and that day's point in the menstrual cycle don't fit into a single sentence.

The sensation is generally concentrated at three points. The first is the speculum: cold and pressure, not cutting. The second is the tenaculum or equivalent instrument holding the cervix: brief, not like a needle, a pulling sensation. The third is the inserter passing through the canal and the device opening in the cavity — this is where the cramp actually occurs. All of these are on the order of minutes; this is not hours of surgical pain.

Cramping and spotting may continue that same day after the procedure ends. This is not proof that "it hurt during insertion, so something went wrong." Fever, foul-smelling discharge, and increasing pain that doesn't subside are a separate matter — that is when you call.

Is anesthesia used when the IUD is inserted?

There is no mandatory general anesthesia. In many cases the procedure ends while talking, under the speculum, with local measures. "Everyone is put to sleep" is not true, and neither is "nothing at all is done."

For women who haven't given birth

The canal is narrow. If the cramp is expected to be significant, two options are discussed. Local anesthesia: numbing applied around the cervix or at the canal opening (gel, spray, or an injected block). The woman is awake, can talk, and gets up sooner. Sedation: brief sleep. This is not the same as operating-room general anesthesia; a breathing tube is not placed in every case. The goal is not to remember those few minutes of the procedure, or to suppress the cramp.

Which option is chosen is assessed based on anxiety, reaction during previous exams, systemic illness, and fasting/medication history. If sedation is requested, driving or going home alone that day is not an option.

For women who have given birth

In most cases, local anesthesia is enough. Gel or a cervical block softens the inserter's passage. Sedation is not the rule for a woman who has given birth; it is discussed separately if there is notable anxiety, a history of a difficult speculum exam, or the doctor's assessment on that day.

Local anesthesia does not guarantee "I won't feel anything." A sense of touch may remain; sharp pain is reduced. Explaining this distinction before the procedure shortens the "it didn't numb" discussion afterward.

Will I feel the IUD being inserted?

Yes, most women feel something. The sensation is not cutting. The presence of the speculum, the cervix being touched, the inserter advancing — these take up space in the body. If sedation is used, those minutes may not be remembered; on waking, cramping can still occur.

A promise of "I won't feel anything at all" isn't made in this text. The accurate statement is: there is no cut; the sensation can be on the scale of menstrual cramps and brief; this sensation may be more pronounced in a nulliparous patient's file; local anesthesia or brief sedation is discussed to reduce that sensation.

Telling cramping apart from a warning sign

Cramping during insertion and on that same day is a brief wave, resembling menstrual pain, that eases when lying down. Walking, talking, and drinking water are not interrupted. The warning side is different: rising fever, foul-smelling discharge, pain that radiates to a shoulder and increases, feeling faint, or bleeding that soaks a pad in a short time. These are not things to wait out at home, assuming "it'll pass."

Rarely, the device does not settle into the cavity, stays in the cervix, or (very rarely) presses against the wall. This is why the cavity may be checked by ultrasound right after the procedure. There isn't a mandatory second appointment stamped on every file; the doctor will say so if the view that day was sufficient. If it wasn't sufficient, the doctor schedules the follow-up themselves.

Copper and hormonal devices go through the same opening

The copper IUD and the levonorgestrel (hormonal) IUD are inserted the same way: cervical canal, inserter, cavity. Any difference in pain comes not from the hormone but from frame thickness, inserter diameter, and the cervix's condition that day. A hormonal device is not marketed as "going in more gently." The monthly bleeding pattern may change afterward; that is a separate matter and doesn't explain that day's cramp.

Does it have to be done during your period?

In the first days of a period, the canal is slightly more open, and the chance of pregnancy reads lower. For this reason, many clinics prefer that window. It is also inserted outside of it. What is required is that pregnancy be ruled out that day and the cavity be measured. The rule "it can only be done while on your period" doesn't bind every case.

Breastfeeding, the postpartum period, after a cesarean

Placement right after childbirth is a separate timing; the risk of bleeding and expulsion is discussed differently. There is no "let's place it right away" package before the postpartum period is over, in this text. In a breastfeeding woman, the choice between hormonal or copper is assessed based on milk and bleeding priorities; the insertion technique is still advancing through the canal. A cesarean scar is on the abdominal wall; the IUD does not pass through that scar.

How the procedure goes in the room

Pregnancy is ruled out first. A day during your period may be preferred; it is not the only mandatory day, but the cavity and canal are more legible at that stage. The speculum is placed. The cervix is visualized. If needed, the cavity is measured by ultrasound. The appropriate IUD is opened. The inserter is advanced along the canal, the device is released, the tube is withdrawn. The threads are left short outside the cervix; the woman does not see them from outside — the doctor checks them at follow-up.

Excluding preparation, the duration in most cases is measured in minutes. The real time is spent in conversation and measurement. A rushed package means the wrong size.

Who is a candidate, and who isn't

An IUD is discussed for a woman who wants contraception, is not pregnant, and whose uterine cavity is assessed as suitable. Active pelvic infection, unexplained bleeding, suspected pregnancy, an unsuitable cavity shape — these stop the procedure that day. Allergy, or a restriction related to copper or hormones, changes the model choice; it doesn't mean "no IUD at all is possible."

After the procedure

Spotting and cramping may occur that same day. Pain relief is used to the extent the doctor advises. Fever, foul odor, progressively increasing pain, or a feeling of fainting are not the expected cramp. For intercourse and tampon use, whatever the doctor said that day applies; a general internet timeframe doesn't bind that particular case.

The follow-up isn't locked to the same week in every case. If confirming that the threads are in place and the device remains in the cavity is wanted, ultrasound is requested. Spontaneous expulsion is rare; "never follow up at all" isn't the rule either.

Short answers to this page's search questions

Common misconceptions

Three things to ask before the exam

Have you given birth, and how. Is there a current possibility of pregnancy. Have you ever had cramping severe enough to feel faint during a previous speculum exam or smear test. These three shorten the discussion of whether local anesthesia or sedation will be used. A model name picked from the internet doesn't substitute for proper sizing.

The order of things at Şişli Fulya

At SoftCare Clinic, the consultation and exam come first. The IUD is not sold as a package. A day and model are not given until pregnancy, infection, and cavity size are clear. Birth history — none, vaginal, or cesarean — changes the anesthesia option. The decision is made in the room, with consent.

Appointments: +90 212 241 30 10 · softcareclinic.com · Fulya Mah. Bahçeler Sk. No: 19/1, Şişli / Istanbul

This text does not replace an examination. Pain threshold, anesthesia choice, and model are determined by that day's examination and tests.