Table 4.
Post-IUD instructions for patients
| • Postinsertion pain |
| • Most women have mild to moderation cramps for the first day or so. |
| • Ibuprofen 400 mg or naproxen 200 mg are available without a prescription and are helpful. Take as directed and with food. |
| • If pain is severe or you also have fever, CALL THE OFFICE at ________________. |
| • No tampons, no douching, no sex (don’t put anything in your vagina) for the next 24 hours. |
| • What to expect with bleeding |
| • Bleeding or spotting are common for the first few days or so. |
| • With the hormone IUD (Mirena®/Skyla®): |
| • Most women have unpredictable bleeding for 1–3 months. |
| • After the first few months, most women have regular bleeding that gets lighter and lighter. |
| • One year after insertion, 20%–60% of women have stopped their periods. |
| • With the copper IUD (Paraguard®, Teva Pharmaceuticals USA, Sellersville, PA, USA): |
| • Most women continue to have regular monthly periods. |
| • Bleeding may get somewhat heavier with the IUD than before. |
| • Cramping may be somewhat worse. |
| • Ibuproen 400 mg or naproxen 200 mg are available without a prescription and are helpful. Take as directed and with food. |
| • To be sure that the IUD is still in place: |
| • You can reach inside your vagina to feel the string. |
| • Placement will be confirmed at your 2-week follow-up visit. |
| • An IUD does not protect against STDs. USE A CONDOM every time you have sex. |
| • Write down the dates of your periods and all bleeding. |
| • Call the office if: |
| • You have a fever or chills and lower abdominal pain. |
| • You have a vaginal discharge. |
| • You are worried about an STD. |
| • You have pain or bleeding with sex. |
| • You think you are pregnant. |
| • You have unusually heavy bleeding. |
| • Come back to the office in 2 weeks to let us check for the string. |
Notes: Modified from J Adolesc Health, 52, Adams Hillard PJ, Practical tips for intrauterine devices use in adolescents, S40–S46, Copyright © (2013), with permission from the Society for Adolescent Health and Medicine.
Abbreviations: IUD, intrauterine device; STD, sexually transmitted disease.