Getting an intrauterine device (IUD) is a big, empowering decision. It offers long-lasting, highly effective contraception with almost zero day-to-day upkeep. Still, that first insertion appointment can feel intimidating, especially with all the conflicting stories online. This guide walks you through practical, evidence-informed ways to prepare your mind and body so you can go in calm, informed, and as comfortable as possible.

Start with solid information

Understanding what’s going to happen takes a lot of the fear out of it. An IUD is a small, T-shaped device placed inside the uterus by a trained clinician in a short in-office procedure, usually just a few minutes of actual insertion time. There are hormonal and non-hormonal (copper) options, each with different side-effect profiles and benefits. Ask your clinician about:

• Which type fits your goals (lighter periods vs. hormone-free).
• How long each brand lasts.
• Typical side effects in the first 3–6 months.
• Pain-management options available at your clinic (e.g., NSAIDs, local anesthetic, cervical block, anxiety medication if appropriate).

Bring your questions on paper or in your phone’s notes. Walking in informed turns “unknown pain” into “expected sensations,” which your brain handles far better.

Tune your mindset

It’s normal to feel nervous before your first iud insertion. Two mental strategies help:

• Name and normalise your feelings. Try: “I’m excited for long-term birth control, and I’m anxious about a new body sensation. Both are valid.”
• Rehearse the timeline. Picture the steps: check-in, consent, pelvic exam, measuring the uterus (cramping), device placement (cramping), done. Knowing the sequence makes the experience feel shorter and more predictable.

If you have a history of medical anxiety, vasovagal reactions (feeling faint during procedures), or past pelvic pain, tell your clinician in advance. Many clinics can adjust the environment (dim lights, extra time, a support person present) and use additional pain-control options.

Practical planning (1–7 days before)

• Medication check: If you can take NSAIDs, many clinicians suggest ibuprofen or naproxen 30–60 minutes before your appointment to help with cramping. Confirm dose and timing with your provider.
• Transportation: Arrange a ride or plan a gentle route home. Most people can drive, but if you’re worried about cramping or dizziness, a ride removes pressure.
• Schedule smart: Avoid stacking high-stakes tasks right after the appointment. Give yourself the rest of the day to relax, if possible.
• Cycle timing: Insertions can be done at any point unless your clinician advises otherwise. Some prefer during or right after a period when the cervix may be slightly more open. If you’re not on a period, that’s usually fine too—follow your clinic’s guidance.
• Support person: If allowed, bring someone who can sit with you before/after. If not, set up a phone check-in.

Day-of physical prep

• Eat and hydrate. A light meal and fluids reduce the chance of lightheadedness. Avoid going in on an empty stomach.
• Comfortable clothing. Wear a loose dress or soft pants and underwear that can accommodate a pad afterwards.
• Heat pack & supplies. Pack a small heat pack, a sanitary pad (you may spot), and water. Some people like peppermint oil or gum to help with nausea.
• Breathing plan. Pick a calming breath cycle—four in, six out—and practice it in the waiting room. Long exhales dampen your body’s stress response.

During the appointment: what sensations to expect

You’ll undress from the waist down and lie back. The clinician inserts a speculum, cleans the cervix, and may use a local anesthetic. The most intense sensations are usually:

• Tenaculum pinch: A brief, sharp pinch on the cervix (some clinics numb first).
• Sounding (measuring the uterus): A strong cramp—often the peak discomfort.
• IUD placement: Another cramp as the arms open and the device is placed.

Many people describe these as “strong period cramps” lasting seconds to a minute. Use your breath, drop your shoulders, unclench your jaw, and ask for a pause if you need one. Some clinics will coach you to exhale during the cramp; others offer distraction (music, counting). If you feel faint, say so immediately; they can lower the head of the table and support you through it.

Immediately after: the first 24–72 hours

• Cramps and spotting: Common and typically manageable with NSAIDs, heat, rest, and gentle movement. Light spotting may persist for days to weeks.
• Activity: Most people can return to normal activities the same day; listen to your body. Avoid new intense workouts the first day if you’re crampy.
• Strings check: Your clinician will trim strings; you may be taught how to feel for them near the cervix. It’s okay if you don’t want to check—there’s usually a routine follow-up in 4–8 weeks.

Longer-term adjustment

• Hormonal IUDs: Irregular spotting is common for 1–3 months, often improving to lighter periods or no periods for some users.
• Copper IUD: Periods can be heavier or crampier at first, often easing after a few cycles. Magnesium, NSAIDs at the start of menses, and a heating pad can help—discuss a plan with your clinician.

Track your symptoms in a notes app or cycle app to spot trends and bring specifics to follow-ups.

Red flags: when to call your clinician

Seek care if you experience:

• Fever, chills, or foul-smelling discharge.
• Severe pelvic pain that doesn’t respond to pain relief.
• Heavy bleeding soaking a pad every hour for several hours.
• Inability to feel strings plus unusual pain or pregnancy symptoms.
• Symptoms of pregnancy or a positive test.

These are uncommon, but timely evaluation matters.

Comfort menu: advocate for what you need

It’s okay—encouraged, even—to ask for:

• A cervical numbing injection or a topical anesthetic.
• Smaller speculum, gentle communication, or a chaperone/support person.
• A break between steps, music, or guided breathing.
• Lying flat a few minutes post-procedure before standing.

Your comfort is part of the procedure, not an extra.

Mini packing list

• Photo ID, insurance (if applicable).
• Pad or pantyliner.
• Water bottle and light snack.
• Heat pack (reusable or disposable).
• Comfy underwear and loose pants.
• Headphones with a calming playlist or podcast.

Bottom line

Preparing for an IUD insertion is about reducing unknowns, supporting your body, and advocating for your comfort. With a solid plan—info, breath, heat, and aftercare—you’ll likely find the procedure brief and manageable, and you’ll walk away with reliable birth control that serves you for years.