Pain Management for IUD insertions
Updated to reflect May 2025 ACOG Guidelines
IUDs are amazing—highly effective, low maintenance, and long-lasting. But let’s be honest: the fear of insertion stops some people from getting one. The good news? You’ve got options. Here’s how to make the process easier and less painful.
In May 2025, the American College of Obstetricians and Gynecologists (ACOG) released new recommendations on managing pain for procedures like IUD insertions (FINALLY!!!!). That means you now have more power to ask for options that make this process more comfortable. You can reference these updated guidelines when speaking with your provider.
Here’s a breakdown of the pain relief options available:
1. Over-the-Counter Pain Relievers
Take ibuprofen (Advil, Motrin) or naproxen (Aleve) 30–60 minutes before your appointment.
Suggested dose: 600–800 mg ibuprofen or 220–440 mg naproxen
These help with cramping after the procedure, but ACOG now says they don’t help much with pain during the insertion itself.
2. Numbing Injections (Paracervical Block)
A local anesthetic injected around your cervix can seriously reduce pain during the insertion.
ACOG now recommends this as a best practice.
It only takes a few extra minutes, and you can ask for it.
3. Numbing Gel or Spray
Lidocaine gel or spray can be applied to your cervix.
This may help a bit, but it’s not as effective as an injection.
Sometimes this can be done prior to the numbing injection
4. Cervical Softeners
Medications like misoprostol can be taken before your appointment to soften your cervix.
This can make the insertion easier—especially if you haven’t given birth.
May cause side effects like cramping or nausea.
5. Managing Anxiety
Feeling anxious can make pain feel worse. Try:
Deep breathing
Calming music
Progressive relaxation
You can also ask your provider for a one-time anti-anxiety prescription (like Xanax). If you go this route, bring a driver.
6. Nitrous Oxide (Laughing Gas)
Some clinics offer nitrous oxide to help you relax.
It won’t block sharp pain but can make the overall experience more bearable.
Often not covered by insurance—ask ahead.
7. Sedation
In some cases, IV sedation or general anesthesia may be an option.
This is harder to access and usually requires more scheduling.
If you need your IUD soon, this might not be the fastest route.
Aftercare Tips
Mild cramping is common for a few hours or days.
Use a heating pad or warm bath for relief.
Keep taking ibuprofen or naproxen as needed.
The Bottom Line
You deserve options—and your provider should walk you through them. ACOG now says:
Pain management should be offered to every patient.
Care should be trauma-informed and culturally competent.
You should be included in the decision-making.
If your provider isn’t offering pain relief or seems dismissive, you have every right to push back or seek a second opinion.
Take Back Trust is here to remind you: You deserve pain management that respects your body, your history, and your choice.
Discussing Options with Your Provider: Everyone’s pain tolerance and experiences are different, so it’s a good idea to discuss these options with your healthcare provider in advance. They can help you decide on the best approach for pain management during your IUD insertion.
