What to expect after getting your IUD.

What to Expect in the First 90 Days After an IUD Insertion

Choosing an IUD is one of the most effective and low maintenance birth control decisions you can make. Whether you choose a hormonal option or a non hormonal copper IU, many people love that an IUD provides long term protection without needing to remember a pill each day. Still, the first three months with an IUD can feel unfamiliar. Your body is adjusting to a new device, your hormones may be shifting, and your menstrual cycle often changes before things settle into a predictable rhythm.

At Maud Medical Clinic in Calgary, our patients often arrive with the same question. What is normal after an IUD insertion, and what should I expect over the next few weeks. Understanding this timeline can help you feel prepared, confident, and supported as your body adjusts. Here is what typically happens in the first ninety days and how to know when it is time to reach out to a doctor.

Immediately After Your Appointment

Right after an IUD insertion, it is very common to feel cramping similar to a strong menstrual period. This may last for a few minutes or for several hours. Some patients may experience lightheadedness or nausea from the procedure, especially if they are sensitive to cervical manipulation. Many people prefer to rest for the remainder of the day, use a heating pad, or take an over the counter pain reliever if recommended by their doctor.

Light period spotting is very normal during the first twenty four to forty eight hours. This may be light or moderate. You can resume normal activities as soon as you feel ready, including walking, working, or gentle movement.

The First Week

During the first week, your uterus is getting used to the presence of the IUD. Cramping may come and go, especially in the evenings or when you are physically active. This does not mean the IUD is out of place. It simply reflects the body’s process of adjusting.

Sexual activity is usually safe as soon as you feel comfortable, but your doctor may recommend avoiding penetrative intercourse or tampons for the first forty eight to seventy two hours to reduce the risk of infection. Hormonal IUDs begin to work quickly, but your physician will let you know if you need backup protection for seven days. Copper IUD tend to work immediately.

Weeks Two to Four

During the next few weeks, you may notice changes in your cycle, especially if you have a hormonal IUD. This is the phase where irregular bleeding is most common. You may have unpredictable spotting, short bursts of bleeding, or longer periods than usual. Cramping may still appear, although it usually becomes milder.

Hormonal IUDs release a small amount of levonorgestrel directly into the uterus. As your body adjusts, your uterine lining begins to thin. This is why spotting is so normal. For many people, this spotting begins to decrease by the third or fourth week.

If you have a copper IUD, the opposite may happen. Because there are no hormones, many users experience heavier periods and stronger cramps at first. This side effect often improves over time, but the first cycle is often the most noticeable.

Weeks Four to Eight

By the one to two month mark, the first phase of adjustment is usually over. Cramping lessens, and spotting begins to stabilize. Many people notice their cycle becoming more predictable again, though not always identical to their previous pattern.

Here is what usually happens during this period:

• Hormonal IUD users often notice lighter periods or shorter cycles.
• Copper IUD users may still experience heavier bleeding, though some reduction in cramping typically begins by the second or third period.
• PMS symptoms may shift. This can include changes in mood, acne, breast tenderness, or bloating. Some people experience improvements, while others notice temporary fluctuations.

Weeks Eight to Twelve

By two to three months, the majority of IUD users are fully adjusted. Your cycle should be more predictable, cramping should be minimal, and spotting should be far less frequent.

For hormonal IUDs, this is usually when the benefits become the most noticeable. Many people have very light periods, and some have no period at all. PMS symptoms often improve, especially for those who previously experienced heavy bleeding or painful cycles.

Copper IUD users generally find that their cramps and bleeding are beginning to level out. For some, heavier periods remain a long term pattern, but many people report that their cycles stabilize significantly around the three month mark.

Emotionally, this is also the point at which many patients feel much more comfortable and confident with their IUD. You know how your body responds, you understand your cycle patterns, and you know what to look for.

Signs You Should Contact a Doctor

While most side effects are normal during the first three months, it is important to know when to reach out for care. Contact your doctor if you notice any of the following:

• Severe pelvic pain that does not improve
• Heavy bleeding that soaks through a pad in under two hours
• Fever or chills
• Foul smelling discharge
• Inability to feel IUD strings after previously being able to feel them
• Strings that feel significantly longer or you suspect the IUD may have shifted
• Persistent pain during sex

At Maud Medical Clinic in Calgary, our physicians and pelvic health team are experienced in troubleshooting concerns and providing gentle, informed care. There are no bad questions when it comes to your reproductive health. If something feels off it's always a good idea to reach out.

How Maud Medical Supports You During the Adjustment Period

The IUD journey does not end at the insertion appointment. The first few months can bring questions, new sensations, and uncertainty. Our clinic is dedicated to helping you feel empowered throughout this entire process.

• Our physicians take the time to explain what you can expect during each phase of adjustment.
• Our pelvic floor physiotherapists can help with persistent cramping or tension.
• Our team provides a education focused and patient centered approach at every step.

Symptoms are different for everyone, this blog is purely written for educational purposes, book with a Maud Medical physician for more information.

Book your IUD now!

Sources
MyHealth Alberta — Intrauterine devices (IUD) overview

SOGC Clinical Practice Guideline — Intrauterine Contraception

Canadian Paediatric Society — Youth IUD recommendation
Maud IUD