As a nurse practitioner who inserts IUDs regularly, I hear some version of "I'm scared" from nearly every patient. And my response is always the same: that's completely understandable, and we're going to make this as comfortable as possible.
Fear around IUD insertion is one of the biggest barriers to people getting what is, for many, the most effective and convenient form of birth control available. I want to talk about where that fear comes from and what we can actually do about it.
Where the Fear Comes From
Most IUD anxiety falls into a few categories:
Stories from friends or the internet. Everyone knows someone who had a terrible experience. And those stories are real — but they usually happened at practices that offered little to no pain management.
Fear of the unknown. Not knowing what the procedure involves or what it will feel like is often worse than the procedure itself.
Previous bad experiences. If you've had a painful pap smear, a rough IUD insertion, or any negative healthcare experience, it makes sense that you'd be anxious about going through something similar again.
General medical anxiety. Some people experience anxiety in any medical setting. That's valid, and it doesn't mean you should have to suffer through procedures without support.
What Actually Helps
Here's what I've seen make the biggest difference for my patients:
A consultation first. We don't jump straight to insertion. We start with a conversation — in person or via telehealth — where we discuss which IUD is right for you, walk through exactly what will happen, and make a comfort plan together. Knowing what to expect removes a huge amount of anxiety.
Real pain management. We use nitrous oxide, TENS therapy, heating pads, and cervical blocks for every IUD insertion. Not as an add-on. Not for patients who ask nicely. For everyone, because it should be standard.
Your pace. We never rush. If you need a break, we take a break. If you need to stop, we stop. You're always in control.
Honest communication. I tell patients exactly what I'm doing and what they'll feel at each step. No surprises.
The Outcome
The vast majority of my patients tell me afterward that it was much better than they expected. Some say they barely felt anything. That's not because they got lucky — it's because we took their comfort seriously.
If fear has been keeping you from getting an IUD, I want you to know that it doesn't have to be the experience you're dreading. There are practices that will meet you where you are.
Schedule a Sedation Gynecology Consultation to talk through your options, or learn about our sedation approach.