Cramping and pain relief

After your hormonal intrauterine system (IUS) fitting, it’s completely normal to experience mild abdominal cramping in the first few days following insertion as your body adjusts to the presence of the device. You can take over-the-counter pain relief, such as paracetamol or ibuprofen, if these are suitable for you. If the pain becomes difficult to tolerate or persists beyond the first few days, please contact your GP for further assessment.

Preventing infection

There is a slightly elevated risk of infection in the first few weeks after your IUS is fitted. This is because the process of inserting the device involves passing through the cervix into the uterus, which can introduce bacteria from the vaginal canal into the upper reproductive tract. While this risk is considered low, it’s important to monitor your body for signs of possible infection during this initial adjustment period. Please seek medical advice if you experience any of the following:

• Persistent or worsening abdominal or pelvic pain
• A fever or raised temperature
• Unusual and/or heavy vaginal discharge

If you’re concerned, contact your GP or call NHS 111 if your practice is closed. Prompt treatment will be able to resolve most infections quickly and prevent further complications that may result in the removal of your device.

Using tampons or menstrual cups

We advise avoiding internal menstrual products – such as tampons and menstrual cups – for the first four weeks after your IUS insertion in order to reduce risks of infection. After that, it’s safe to use them, but take extra care during light bleeding days.

On rare occasions, the device threads may become tangled with a tampon or an IUS may dislodge if the suction from a menstrual cup is not broken properly before removal. If this happens, please avoid using any further internal products and contact your GP as soon as possible to check the position of your IUS. In most cases, a quick examination or ultrasound can confirm whether the device is still in place and functioning correctly.

Changes in bleeding patterns

Irregular menstruation or spotting (light vaginal bleeding that occurs outside of a regular menstrual period) is common in the first few months after your IUS is fitted. This usually settles naturally over time. Many people find that their periods become much lighter and, for some, they may stop altogether.

Pregnancy and protection

It takes 7 days for a hormonal IUS to become fully effective. During this time, use condoms or another form of barrier contraception to prevent pregnancy. Although the IUS is highly effective, if you’re ever concerned about pregnancy, take a test and contact your GP or local sexual health service for advice.

Thread checks

We recommend checking the IUS threads 4–6 weeks after your fitting appointment. These are thin threads that sit high in the vaginal canal and allow both you and your clinician to confirm that the device is still correctly in place. For more detailed instructions on how to check the IUS threads, please refer to our FAQ section.

If you’re comfortable with doing so, you may wish to check the threads each month. If you’re comfortable with doing so, you may wish to check the threads each month. If you cannot feel them – or if you feel something firm, like a matchstick, near the cervix – please contact your GP for further assessment. If you are unable to check the threads yourself or would prefer not to do so, please make an appointment at your GP practice so a practice nurse can check them for you.