Many women experience cramping during an intrauterine device (IUD) insertion and for a short time afterward.

To insert an IUD, your doctor pushes a small tube containing the IUD through your cervical canal and into your uterus. Cramping — much like during your period — is your body’s normal reaction to your cervix opening. How mild or severe it is will vary from person to person.

Some people find the procedure no more painful than a Pap smear and experience only mild discomfort after. For others, it can cause pain and cramping that lasts for days.

Some people may only experience minor pain and cramping if they’ve typically had mild cramps during their periods, or if they’ve previously delivered a baby. Someone who’s never been pregnant, or has a history of painful periods, may have stronger cramps during and after insertion. This may be true for only some people. Everyone is different.

Keep reading to learn more about what to expect from your cramps, when you should see your doctor, and how to find relief.

The main reason most women cramp during and after an IUD insertion is that your cervix has been opened to allow the IUD to fit through.

Everyone’s experience is different. For many, the cramps will start to subside by the time you leave the doctor’s office. However, it’s perfectly normal to have discomfort and spotting that lasts for several hours afterward.

These cramps may gradually decrease in severity but continue on and off for the first few weeks after insertion. They should subside entirely within the first three to six months.

See your doctor if they persist or if your pain is severe.

How your IUD affects your monthly cycle depends on the type of IUD you have and how your body reacts to the IUD.

If you have a nonhormonal copper IUD (ParaGard), your menstrual bleeding and cramping may increase in intensity and duration — at least at first.

In a study from 2015, three months after insertion, more than 70 percent of copper IUD users reported heavier bleeding than before. But by six months after insertion, less than half reported increased cramping and heavier bleeding. As your body adjusts, you may also find that you spot or bleed between your periods.

If you have a hormonal IUD such as Mirena, your bleeding and cramping may become heavier and irregular for the first three to six months. About 30 percent of women in the study reported increased cramping three months after insertion, but 25 percent said their cramps were actually better than before.

You may also have a lot of spotting over the first 90 days. Two-thirds of women reported lighter bleeding than before at the 3-month mark. After 6 months, about 60 percent of women reported less bleeding than they’d had at the 3-month mark.

Regardless of your IUD type, your bleeding, cramping, and between-period spotting should decrease over time. You may even find that your periods stop altogether.

Immediate ease

Although your cramps might not go away completely, you may be able to ease your discomfort with some of the following:

Over-the-counter pain medication

Try:

You can talk to your doctor about a good dosage for relief from your cramping, as well as discuss any drug interactions you may have with other medications you take.

Heat

A heating pad or hot water bottle may be your best friend for a few days. You can even fill a sock with rice and make your own microwaveable heat pack. Soaking in a warm bath or hot tub may also help.

Exercise

Throw on your sneakers and get out for a walk or some other activity. Being active can help ease cramps.

Positioning

Certain yoga poses are said to reduce cramps by stretching and loosening painful muscles. These videos are a good place to start, which include some great poses you can try at home: Pigeon, Fish, One-Legged Forward Bend, Bow, Cobra, Camel, Cat, and Cow.

Acupressure

You can put pressure on certain points to help relieve your cramps. For example, pressing into the arch of your foot (about a thumb width from your heel), may bring relief.

Long-term strategies

If your cramps last for more than a week, you may want to talk to your doctor about long-term strategies for relief. Some things to consider include:

Supplements

Vitamin E, omega-3 fatty acids, vitamin B-1 (thiamine), vitamin B-6, magnesium, pycnogenol, and fennel are a few supplements that may help reduce cramps over time. Be sure to talk to your doctor about what you’d like to try and how you can add them to your routine.

Acupuncture

You may find it beneficial to see a licensed professional about acupuncture. Stimulating specific points on your body by inserting extremely thin needles through your skin has been found to relieve menstrual cramps.

Transcutaneous electrical nerve stimulation (TENS)

Your doctor may be able to recommend an at-home TENS device. This handheld machine delivers small electric currents to the skin to stimulate nerves and block pain signals to your brain.

Some people just don’t tolerate having a foreign body in their uterus. If so, your cramps may not go away.

If your cramping is severe or lasts for 3 months or more, it’s important to call your doctor. They can check to make sure the IUD is in its proper position. They’ll remove it if it’s out of position or if you just don’t want it anymore.

You should see your doctor right away if you begin experiencing:

  • severe cramping
  • unusually heavy bleeding
  • fever or chills
  • unusual or foul-smelling vaginal discharge
  • periods that have slowed or stopped, or bleeding that’s much heavier than before

These symptoms may be a sign of an underlying concern, such as infection or IUD expulsion. You should also call your doctor right away if you believe you may be pregnant, can feel the IUD coming out through your cervix, or the IUD string length has changed suddenly.

If your IUD string is easily accessible, your doctor will likely be able to remove your IUD quickly and without any complications. You may experience mild cramping, but it likely won’t be as intense as what you experienced with insertion.

If your IUD strings have coiled up through the cervix and are sitting in the uterus, removal may be more difficult. If you have a low threshold for pain — or had a difficult time with the initial insertion — talk to your doctor about your options for pain relief. They may be able to numb the area with lidocaine or offer a numbing shot (cervical block) to help reduce the sensation.

If you’d like to get a new IUD inserted to replace the one that was just removed, you may have some cramping like you did the first time. You can reduce your risk for cramping by scheduling your appointment during your period, or when you would’ve had it. Your cervix sits lower during this time making reinsertion potentially easier.

If you’re experiencing cramps after insertion, you aren’t alone. Many women experience cramps immediately after the procedure, and these cramps may continue over the coming months. This is usually a natural result of your body adjusting to the device.

If your pain is severe, or if you experience other unusual symptoms, see your doctor. They can make sure your IUD is in place and determine whether your symptoms are cause for concern. They can also remove your IUD if you no longer wish to have it.

Oftentimes, your body will adjust to the IUD within the first six months. Some women may find that it can take up to a year before their symptoms completely subside. Always check with your doctor if you have questions or concerns.