Getting an IUD or Implant: What the Appointment Is Actually Like
In 2024, the CDC updated its guidance to explicitly recommend that providers counsel patients on pain management options before IUD placement — a real, recent shift that reflects years of patients reporting their pain wasn't being taken seriously. Here's what the appointment actually involves and what's reasonable to ask for.
Last updated August 2026
What actually happens during IUD insertion
A speculum is placed, the cervix is cleaned, the uterus is measured ("sounding") to check depth and direction, and the IUD is placed through the cervix into the uterus using a thin insertion tube. The whole procedure typically takes a few minutes; the sounding and placement steps are usually the moments people feel the most.
Why pain varies so much between people
Whether you've had a vaginal delivery, cervical stenosis (a naturally narrower cervical canal), and anxiety or muscle tension all genuinely affect how insertion feels. "Some people feel almost nothing and others find it quite painful" is an accurate description of the real range, not something said just to be reassuring — your experience isn't wrong if it doesn't match what a friend described.
Pain management options worth asking about
NSAIDs taken beforehand have modest evidence for reducing pain. Topical lidocaine gel or spray applied to the cervix is increasingly used. A paracervical (cervical) block — lidocaine injected directly around the cervix — meaningfully reduces pain for many people and is increasingly recommended as a standard offer, not a special request. For people with significant anxiety or a previous difficult insertion, deeper sedation or anesthesia is a legitimate option to raise, not "asking for too much."
The implant is a different, usually easier, experience
Nexplanon (the implant) is placed under the skin of the upper arm using local anesthetic injected at the site — the main sensation is that local injection itself, and the placement afterward is typically quick and far less variable in discomfort than IUD insertion.
What's normal afterward vs. what's not
Cramping and spotting are common for days to a few weeks after IUD placement. Signs of possible expulsion — not being able to feel your IUD strings, feeling the hard plastic of the device itself, or unusually heavy bleeding — are worth a check-in. For the implant, bruising at the insertion site is normal, but you should always be able to feel the rod-shaped device just under the skin; if you can't, that's worth prompt follow-up.
Worth discussing with your provider
Educational information only — general patterns that vary by person. This is not medical advice, a diagnosis, or a substitute for care from your own clinician.
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