Paragard IUD Insertion and Removal: What to Expect

Paragard IUD Insertion and Removal

The Paragard IUD is a highly effective, long-lasting birth control option for women. It’s a T-shaped device made of flexible plastic that contains copper. The copper disrupts sperm function, preventing pregnancy for up to 10 years. While the Paragard IUD is a reliable choice, understanding the insertion and removal processes can help you feel more prepared and confident.

How To Prep Pre-Appointment

Use your initial consultations to discuss all possible birth control options with your doctor. They will review your medical history and perform a pelvic exam to ensure the Paragard IUD is right for you.

Some women experience cramping during insertion. Talk to your doctor about pain management options like over-the-counter pain medication or a local anesthetic. Plan to be at the doctor’s office for about 30 minutes, although the insertion itself typically only takes a few minutes.

In a recent news story highlighting the first hand pain some women experience, Cara McCaskill, expecting minor discomfort, endured an agonizing 15-minute ordeal. While IUDs are highly effective and convenient birth control, McCaskill’s story isn’t uncommon. 

Research now suggests the pain can vary widely, with some women left traumatized. Viral videos on social media capture these negative experiences, sparking discussion about better pain management options. 

However, studies also show many tolerate the procedure well without strong pain meds. With more women sharing their stories, the conversation is shifting towards ensuring all women have a clearer picture of the potential realities of IUD insertion.

The Insertion Process

A recent Washington Post article sheds light on the growing conversation about IUD insertion pain, particularly among younger women on social media. Researchers analyzed top #IUD videos on TikTok and found a dominant theme of pain and lack of adequate pain management options. Dr. Jenny Wu, who led the study, highlights the emotional toll of these experiences for women seeking a reliable birth control method.

The article acknowledges how the American College of Obstetricians and Gynecologists (ACOG) recognizes the discomfort for many women, but hasn’t identified a universally effective pain management strategy. 

Additionally, research suggests a significant disconnect between how women perceive their pain during insertion and how healthcare providers estimate it. This highlights the need for improved communication for a more positive IUD insertion experience.

This is what you can expect as part of the insertion process:

  1. Preparation: You’ll lie on an exam table with your legs in stirrups and your doctor will clean your vagina and cervix with an antiseptic solution.
  1. Speculum Placement: A speculum will be inserted to hold the vagina open and provide a clear view of the cervix.
  1. Sounding: A thin, flexible rod called a sound is used to measure the depth and direction of your uterus.
  1. Insertion: The Paragard IUD is folded and inserted into a narrow applicator tube, which your doctor will guide through your cervix and into your uterus. Once positioned correctly, the Paragard IUD is released from the applicator and unfolds into its T-shape. The applicator is then removed.
  1. String Check: Your doctor will trim the strings attached to the IUD, leaving short tails hanging out of your cervix. These strings allow for easy removal in the future.

Potential Side Effects

You may experience cramping during and after insertion, for which over-the-counter pain medication or a heating pad can help. Light spotting or bleeding is commonly experienced for a few days, with your first few period cycles becoming heavier or more painful. In some cases, the IUD may expel itself from the uterus unnoticed. Perform a monthly string check to ensure the IUD is in place.

According to TorHoerman Law, while the Paragard IUD is generally safe and effective, some women have experienced complications. A small number of lawsuits have been filed against the manufacturer alleging the IUD can break or perforate the uterus during insertion. 

A Paragard lawsuit is complex since this is a legal landscape that is still evolving. If you have experienced complications with your Paragard IUD, it’s important to consult with a lawyer specializing in medical device litigation to understand your legal options.


Another woman, Ashley B., spoke to about facing a different kind of IUD challenge. Hoping for a low-maintenance birth control option, she opted for the copper IUD to avoid hormonal side effects. Unfortunately, after a month of intense pain, she had it removed. Her doctor suspected Ashley’s uterus might be too small for the standard IUD size. This is why pre-insertion discussions are a must to minimize discomfort.

Removal Process

The good news is that the Paragard IUD can be removed at your convenience, regardless of whether you’ve had children. The removal process itself is similar to insertion, but generally quicker and with less discomfort.

This is what to expect when you go in:

  1. A speculum is inserted to visualize the cervix.
  1. Your doctor employs forceps to hold and gently pull the IUD strings to remove the device.
  1. Your doctor will confirm the IUD has been removed completely.

Some cramping and bleeding after removal is normal. You are fertile again immediately after the IUD is removed.


  1. Can I Get Pregnant With the Paragard IUD? 

Its effectiveness rate is over 99%, meaning less than 1% of women using it will get pregnant each year. However, no birth control method is 100% foolproof. Factors like incorrect insertion or expulsion of the IUD can increase the risk. If you experience missed periods, unusual cramping, or any concerns, it’s crucial to see your doctor for a pregnancy test and to check the IUD’s placement.

  1. How Often Should I Check the Strings? 

It’s recommended to feel for them at least once a month, ideally during showering or whenever you can comfortably check. Reach inside your vagina and feel the tips of the strings hanging to confirm the IUD is still in place and effectively preventing pregnancy. If you can’t feel the strings or they seem shorter than usual, don’t use tampons and contact your doctor right away to schedule a check-up.

  1. What Happens if the Paragard IUD Breaks? 

While most removals go smoothly, if the IUD breaks during removal, it may require a more complex procedure to remove all the pieces. If you experience severe pelvic pain, cramping that worsens over time, or unusual vaginal discharge with a foul odor following insertion or removal, these could be signs of a broken IUD or infection.

In conclusion, the Paragard IUD offers a highly effective and long-lasting birth control solution for many women. Understanding the insertion and removal processes can ease any anxieties and help you feel prepared. Regular string checks and open communication with your doctor are essential for maintaining peace of mind and ensuring the IUD’s effectiveness. If you have any concerns about Paragard – including potential legal issues related to complications – remember, resources are available.