How long does your stomach hurt after inserting an IUD (intrauterine device)

Intrauterine contraceptives differ from other methods of contraception in that their installation requires medical intervention and must be carried out on an outpatient basis. It is prohibited to insert and remove an IUD yourself. Therefore, before the procedure, many women worry whether it will hurt to install the spiral and what sensations they will experience during the installation process. To understand whether it is painful to insert an intrauterine contraceptive, we will consider all the stages of inserting an IUD.

The principle of operation of intrauterine devices.

Basically, the effect of the IUD is due to a mechanical obstacle to the passage of sperm.

In addition, under the influence of the hormonal IUD (Mirena), cervical mucus thickens and ovulation is suppressed. In some cases, fertilization still occurs, BUT in this case, the IUD prevents implantation.

The hormonal IUD can be used not only for contraception, but also for therapeutic purposes, for example, for endometriosis.

With the use of a hormonal IUD, menstruation becomes less abundant and may subsequently disappear completely. This is an expected reaction of the endometrium, and not a side effect. After the IUD is removed, the cycle is restored.

Is there a cure for menstrual pain?

Often women do not strive to get rid of pain, they heroically endure it, considering it the norm and getting used to this condition. Some of them take medications uncontrollably, which only aggravates the situation.

As a result, having gotten used to the pain, a woman may not feel how primary dysmenorrhea has turned into secondary, which can hide a number of gynecological diseases. Therefore, it is important to understand that severe discomfort during menstruation is not the norm.

Modern medicine can provide many ways to get rid of unpleasant sensations. However, it is important to identify the true cause and eliminate it, and not the consequence of the problem.

When is an IUD installed?

With a regular menstrual cycle, a copper-containing IUD is installed in the first 12 days after the start of menstrual bleeding, and a hormonal IUD in the first 7 days. In the case of a hormonal IUD, the contraceptive effect occurs 7 days after installation, so during these days it is necessary to use an additional method of contraception. After installing a copper-containing IUD, you can have open sex life from the moment of installation.

If the menstrual cycle is irregular, an IUD can be installed on any day, provided that the woman is definitely not pregnant! The IUD can be used during breastfeeding (4 or more weeks after birth).

Classification of dysmenorrhea

The answer to the question of why your stomach hurts during menstruation can be answered by a gynecologist. Scientifically, this condition is referred to as dysmenorrhea. Two types of dysmenorrhea can be distinguished depending on the reasons that caused it:

• Primary. This diagnosis is made if the reason why the lower abdomen hurts during menstruation is clearly unknown. In this case, we can often talk about the hereditary nature of the disease. It also affects girls under the age of 25, smokers and those whose first menstruation occurs later than normal. Usually the problem disappears completely with the onset of sexual activity or after the birth of a child.
• Secondary. This type of dysmenorrhea most often occurs in women over 30 years of age and is associated with a gynecological disease and/or previous surgery.

Depending on the severity, three degrees can be distinguished:

1. Mild - moderate stomach pain during menstruation, but the woman is able to tolerate these sensations and continues to lead her usual lifestyle;
2. Moderate - painful periods, accompanied by weakness, nausea, weakness, and unstable emotional state.
3. Severe - unbearably severe pain during menstruation, incapacitating. Accompanied by vomiting, serious malaise, including loss of consciousness.

How is an IUD installed?

Before installing an IUD, you must undergo the following examinations:
1. Ultrasound of the abdominal cavity and ultrasound of the breast

2. Tests for STIs

3. PAP TEST

The installation process itself takes about 20 minutes and takes place on the gynecological chair during the examination. The IUD is inserted into the uterine cavity, leaving control antennae in the vagina (for which the IUD is later removed). They will not cause you discomfort, BUT you need to be more careful when using tampons and removing them, since as a result of lightly tugging on the mustache, the spiral may shift and there will be no contraceptive effect.

The IUD can also be used by nulliparous girls, but there is a risk of the IUD falling out, since the uterus of nulliparous women is smaller.

How is the installation done and is it painful to insert an intrauterine contraceptive?

The procedure takes place in several stages:

1. The patient sits in the gynecological chair. Before inserting the IUD, the doctor palpates the body of the uterus to determine its position and size. This is not painful at all and helps to identify bends or other deviations in the structure of the organ in order to prevent the risk of perforation of the uterine wall when inserting an intrauterine device.
2. The gynecologist then treats the woman's genitals, including the cervix and vagina, with an antiseptic.
3. The doctor inserts a speculum into the vaginal canal to ensure good visibility of the uterine cervix, and then fixes its upper part by grasping it with a special clamp. There is no need to be scared; in fact, it is not as painful and scary as it sounds.
4. Before inserting the IUD, the gynecologist uses a medical probe to take measurements of the uterine cavity. The device is inserted through the cervical canal and allows you to accurately determine the depth of the uterus.
5. Then the specialist places the IUD into a special guide tube, which is supplied with the device, and places it in the uterine cavity.
6. After making sure that the spiral has reached the bottom of the uterus, the doctor removes the guidewire.
7. The gynecologist shortens the antennae of the spiral to 2-3 cm. They are necessary to control the location of the IUD and its subsequent removal.
8. At the final stage, the doctor removes the speculum from the patient’s vaginal canal and removes the clamp. If the woman is not in pain and feels well, she is allowed to go home.

Provided the installation technique is followed and the gynecologist is experienced, inserting an intrauterine contraceptive does not hurt. The device can be installed by a local gynecologist on an outpatient basis. The procedure takes about 10 minutes and does not require anesthesia. If a woman has high cervical sensitivity and is in pain during the installation process, the doctor may use painkillers.

Advantages of contraception using the IUD.

• Long-term contraception: IUD is effective for 5 years
• Reliable method of contraception
• There is no need to monitor the regularity of taking pills, or the position of the patch or vaginal ring
• There are not as many side effects as when taking CHCs, including the IUD does not affect libido and does not increase the risk of thrombosis
• The hormonal IUD has a therapeutic effect in some gynecological pathologies (endometriosis, heavy menstruation, recurrent endometrial polyps)
• The IUD can be used during breastfeeding
• Quite an economical method of contraception

Menstrual pain - is this normal?

Normally, when the ovary hurts before menstruation, the discomfort cannot be too strong. The presence of mild, nagging pain indicates contractions of the muscles of the uterus, which strives to get rid of the “old” layer of the endometrium.

Over the next month, a “new” endometrium is formed, which is necessary for the embryo to attach to it in the event of fertilization.

In the case when the symptoms of menstruation are too pronounced, the bleeding is excessively profuse, we can talk about the presence of the disease dysmenorrhea.

You should, without wasting time, make an appointment with a doctor and find a disorder in the woman’s body, which is indicated by the pain syndrome.

Disadvantages of using an intrauterine device.

• After installing the IUD, pain in the lower abdomen may persist for some time, 1-3 months. During this period, NSAIDs can be used.
• With a copper-containing IUD, menstruation may become more profuse, so much so that the IUD has to be removed.
• There is a risk of the spiral falling out or dislodging; this usually occurs within the first 3 months after installation. Therefore, if you feel that the IUD has fallen out or has shifted, consult a doctor immediately!
• Intermenstrual bleeding often appears, which causes inconvenience, but usually disappears in the first 2-3 months after installation.
• A common side effect during the first time after installation of a hormonal IUD is breast tenderness, headaches and slight weight gain.
• There are risks of pelvic inflammatory disease, so it is important to be screened for STIs before inserting an IUD. If you are concerned about persistent pain in the lower abdomen or pain during sexual intercourse, fever or abnormal discharge from the genital tract, then immediately contact your gynecologist.
• Although the IUD is a reliable method of contraception, BUT a low percentage of the probability of pregnancy still exists!
• It is extremely rare, but when installing an IUD, perforation of the uterus occurs - this is damage to the muscular layer of the uterus by the spiral! To avoid this situation, an OMT ultrasound and measurement of the length of the uterine cavity are performed before installation, and also after installation of the IUD, ultrasound control is necessary!

Causes of pain in the lower abdomen after installation of the IUD

The intrauterine device prevents the fertilized egg from attaching to the lining of the uterus. As a result, pregnancy cannot fully develop. Hormone-containing IUDs are also popular. They not only mechanically prevent normal conception, but also affect a woman’s hormonal levels. The likelihood of complications after the introduction of a foreign body into the uterus is reduced.

The hormonal drug Mirena is widely used, but side effects may occur from the use of such devices. If your lower abdomen hurts after installing the Mirena coil, it is possible that inflammation of the genital organs is developing.

Immediately after installing a contraceptive device, mild discomfort in the lower abdomen and minor spotting are considered normal. If there is heavy bleeding or severe nagging pain is observed for more than two days, you should contact your gynecologist again.

The duration of abdominal pain after the installation of coils should not be long. After injection, the foreign body “takes root.” This means that the lining of the uterus adapts to the new material.

As a rule, unpleasant symptoms disappear completely within a week. However, the entire adaptation process can take up to three months. Nagging pain often appears in the first days of menstruation.

Contraindications to the installation of an IUD.

• Presence of a sexually transmitted infection
• Inflammatory processes of the pelvic organs (including in the postpartum period and the period after termination of pregnancy)
• Cervical cancer, uterine cancer, breast cancer
• Anomalies of the uterus - bicornuate uterus, septum in the uterine cavity
• Submucous uterine fibroids
• Uterine bleeding of unknown etiology
• Pregnancy
• Allergy to copper, Wilson-Konovalov disease - in the case of copper-containing IUDs
• Liver diseases and tumors, hypersensitivity to levonorgestrel - in the case of a hormonal IUD

Author: obstetrician-gynecologist Tarakanova M.Yu.

When to remove the IUD?

The duration of wearing an IUD depends on the type of IUD. The most commonly used IUDs, which contain copper, can remain in the uterus for up to 10 years after insertion. IUDs containing the hormone progesterone are removed 1 year after insertion. Another type of hormonal IUD, which contains a synthetic analogue of progesterone, levonorgestrel, can be used for 5 years. If you are planning a pregnancy or simply no longer want to use an IUD, any type of IUD can be removed by your doctor at any time.

Side effects and contraindications

After installation of the Mirena therapeutic system, side effects rarely develop, but they are still possible. Among the most common complications are the following:

• Individual intolerance to the drug, accompanied by pathological reactions and deterioration in general well-being.
• Frequent headaches, nausea, depressed mood, decreased libido.
• Periodic abdominal pain, bloating.
• Sudden jumps in blood pressure.
• Infections of organs located in the abdominal cavity.
• Failure of the menstrual cycle, manifested by a prolonged absence of menstruation.

Against the background of an implanted intrauterine device, the condition of the skin may worsen. Blackheads, acne, and inflammation appear on the face and body. In extremely rare cases, after the installation of an IUD, cysts form in the myometrium.

The Mirena therapeutic system is not prescribed to patients with suspected pregnancy. In this case, the woman must undergo tests to make sure there is no conception. Also, the IUD is contraindicated for implantation if the following pathologies are diagnosed:

• neoplasms of a malignant nature;
• uterine fibroids larger than 5 cm;
• inflammatory processes in the organs of the genitourinary system;
• congenital or acquired immunodeficiency;
• uterine bleeding of unknown etiology;
• individual intolerance to the active component of the drug.

Removing the spiral

Basically, the spiral is introduced for 5-7 years (this depends on the type of spiral). When the coil expires, it must be removed. To do this, a preliminary consultation with a gynecologist is carried out and smears are submitted for microscopy of the vagina. If there are no contraindications, the doctor removes the IUD during the next menstruation. The procedure is completely painless.

The next IUD insertion is usually recommended no earlier than after 3 months.

Side effects and complications:

• Uterine bleeding – prolonged or heavy menstruation or intermenstrual bleeding.
• Perforation of the uterus (violation of the integrity of the uterus) or injury to the cervix.
• Ingrowth of the spiral, more often with prolonged wear (more than the recommended period).
• Inflammation of the pelvic organs mainly occurs when a woman violates the recommendations.
• Spiral falling out.
• Anemia (low hemoglobin)
• In the first months of using Mirena, an initial increase in spotting and spotting from the vagina may be observed. Then there is a decrease in the duration and volume of menstruation. Scanty bleeding is often replaced by its absence.

With a preliminary consultation with a gynecologist and an examination, all these complications arise extremely rarely.

Benefits of using Mirena

During the conservative treatment of adenomyosis, various hormonal drugs are used, but Mirena has its own advantages:

1. Installation is carried out once every 5 years. Unlike hormonal pills, which must be taken strictly according to schedule, after inserting an intrauterine device, a woman does not need to follow any rules or treatment regimens. The IUD remains effective throughout its stay in the body.
2. Allows you to achieve a therapeutic effect with a minimal dosage of the hormone. The hormone levonorgestrel, which is part of the drug, enters directly into the uterine cavity, exerting a localized effect.
3. Minimal risk of side effects. The drug does not pass through the digestive system, so it does not affect other internal organs.
4. No risk of overdose. During the day, a strictly fixed dose of levonorgestrel is released - 20 mcg.
5. Reliable contraception. After implantation of an intrauterine device, a woman is reliably protected from unwanted pregnancy.
6. Normalization of hormonal levels.

Patients are often prescribed the drug Visanne for uterine adenomyosis. The active ingredient of the product is micronized dienogest - a synthetic hybrid gestagen of the third generation. The drug is available in tablet form and is used for internal and external endometriosis. The doctor must decide which is better - Visanne or Mirena for adenomyosis, taking into account the nature of the disease, the degree of neglect, the presence of indications and contraindications.

The principle of operation of the hormonal intrauterine system

The Mirena therapeutic spiral contains the hormone levonorgestrel from the progesterone group. The hormone is enclosed in a special housing and protected by a membrane that regulates its release. Progestogen is released directly into the uterine cavity, affecting the functioning of the reproductive system.

The principle of operation of the hormonal intrauterine system:

• Reduces the sensitivity of receptors to specific hormones such as estrogen and progesterone.
• Makes the uterine mucosa immune to the female sex hormone estradiol.
• Prevents the growth of new pathological tissues.

Thanks to these medicinal properties, the coil for uterine adenomyosis helps to significantly improve the patient’s condition:

• Normalize the amount of menstrual flow, making it moderate.
• Eliminate pain and discomfort.
• Reduce the risk of uterine bleeding.
• Eliminate secondary anemia caused by excessive blood loss

Scheme for using a hormonal IUD

Before inserting an intrauterine device, simple preparation is required, including the following steps:

• Initial examination by a doctor. During the procedure, the gynecologist assesses the general condition of the patient’s genital tract and excludes contraindications for the use of the drug.
• Testing for sexually transmitted infections. Laboratory procedures such as bacterial culture and survey smear will help identify possible problems. If necessary, tests for viral and intracellular infection are prescribed - PCR, ELISA.
• Ultrasound of the pelvic organs. Ultrasound examination helps to assess the condition of the uterus and appendages, diagnose concomitant pathologies, and determine the degree of progression of adenomyosis.

If there are no contraindications to the insertion of an intrauterine device, the doctor will agree on the date and time of the procedure. The Mirena hormonal system is installed on the 3rd – 7th day of the cycle - at the end of menstruation. During this period, the cervix is ​​dilated, which allows the IUD to be inserted inside without hindrance.

The technology for maintaining the Mirena therapeutic system includes the following stages:

• Control examination and treatment of the genital mucosa with an antiseptic solution.
• Introduction of the mirror.
• Grasp the upper lip of the cervix with special gynecological forceps.
• Checking the patency of the cervical canal and the depth of the uterine cavity with a probe.
• Insertion of a guidewire and an intrauterine device through it.
• Removing the conductor.

After the guide is removed, the IUD remains in the uterus. All manipulations are carried out under ultrasound control, which significantly reduces the risk of side effects. After 5 years the sprial will need to be removed. Premature removal of the system is carried out in the following situations:

• development of unwanted side effects;
• complications arising from the installed IUD;
• pregnancy planning.

Methods of action:

Non-medicated IUDs.

The contraceptive effect is associated with a local aseptic inflammatory reaction. Those. minor inflammation in the uterus occurs not due to microbes, but due to the presence of a foreign body (spiral). Therefore, this process is safe. The spiral, like a foreign body, causes contraction of the muscles of the uterus and increases contraction of the fallopian tubes. Because of this, the fertilized egg (Yes, fertilization can occur with an IUD) moves faster through the tubes and enters the uterine cavity earlier than expected. Because of this, the fertilized egg cannot attach to the walls of the uterus and pregnancy does not develop.

Types of non-medicinal spirals.

• Copper-containing coils - copper enhances the inflammatory response, which makes it more difficult for sperm to penetrate into the uterine cavity, and it is more difficult for the egg to attach to the walls of the uterus (if fertilization does occur).
• Spirals containing silver in the lumen of the leg.

Spirals with gold, in the form of a wire wrapped around the leg.

Silver- and gold-containing IUDs are considered the most effective in terms of contraception (the contraceptive effect reaches 99%), prevent the development of inflammatory diseases, and the duration of action increases to 7–10 years.