An IUD (intrauterine device) is a small, flexible, T-shaped contraceptive device inserted through the cervix into the uterus. It disrupts the flow of sperm and prevents eggs from implanting in the uterine wall. There are two types of IUDs: copper and hormonal. Copper is toxic to sperm. Hormonal IUDs work to thicken mucus around the cervix, preventing sperm from entering.
Some women may experience cramping with the IUD. Duration, onset and severity of cramps can help indicate what is causing them.
Pelvic Inflammatory Disease
It’s normal to experience IUD cramping during the first hours or even days following insertion. If pain is severe, though, it could indicate pelvic inflammatory disease (PID). PID occurs when an infection of the vagina, caused by an STI such as gonorrhea or chlamydia, travels upward into other reproductive organs. When being inserted, an IUD can help spread an infection, if present, from the vagina to the uterus. Women considering the IUD should be tested for STIs first. If you experience severe pain soon after insertion and weren’t tested before, get tested immediately.
Another cause of immediate cramping, usually combined with bleeding and fever, is uterine perforation. This occurs if the IUD is inserted improperly and pokes a hole through the uterine wall. If this occurs, the IUD will be removed, and the hole will often heal up on its own. In rare cases, surgery may be required. Finding an experienced doctor to place your IUD is the best way to avoid this risk.
Some women may experience increased cramping during their menstrual periods when using an IUD. This is almost exclusively connected to the copper IUD, which tends to make menstruation heavier. During menstruation, your body releases a chemical called prostaglandins that cause the uterus to contract, shedding the uterine lining. Contractions of the uterus are the cause of period cramps. The hormonal IUD method tends to make periods less painful.
Though IUDs generally don’t move once inserted, between 2-10% of women experience partial or total expulsion of the devices, according to WebMD’s page on IUDs found at www.webmd.com. Expulsion often occurs during a menstrual period and is more common within the first year of insertion. If the IUD becomes dislodged without exiting the vagina, it can cause significant cramping. Movement of the IUD can usually be confirmed by feeling for the string that exits the cervix. If the string is positioned differently than normal, the IUD has moved. Dislodged IUDs may fail to prevent pregnancy.
IUDs are about 99% effective at preventing pregnancy. In the case of failure, chances of ectopic pregnancy are increased in women with IUDs. An ectopic pregnancy occurs when a fertilized egg attaches to a pelvic organ that is not the uterus; this most commonly occurs in a fallopian tube. Women with cramping coupled with spotting should be tested for pregnancy.
Cramping beyond the first few days with an IUD likely indicates one of the above IUD pain causes. If you’re experiencing cramping, spotting or other symptoms with an IUD, see your doctor.