Getting the IUD Past Your Cervix
In the first case of the woman who worried about dilation she gave us further information. Her goal was to get a Mirena, which is effective for 5 years. It's smaller cousin is now available, and it provides effective 4 year contraception, so that is a consideration. Her only deliveries were c-section deliveries, elective, she didn't have any labor. Although she wants an IUD for her contraception, she knows it has to be inserted through her cervix. She is therefore wondering if she would have difficulty getting an IUD, or extra pain with IUD insertion? ! In truth the cervix needs to be dilated so little with an IUD women who have never been pregnant, let alone whether they have had a delivery can have an IUD with very manageable pain symptoms.
For most women nothing special has to be done. In women who have an abnormality of the cervix there are gyno procedures that can help get the IUD in the uterus. It is possible to image the uterus with transvaginal ultrasound and make measurements in 3 dimensions, or even to use 3-D ultrasound to see the dimensions of the uterus if necessary prior to an ultrasound. It's not usually necessary. A pelvic exam can detect active infections, but without infection the risk of getting an infection is very low (under 2%) and even with an undetected gonorrhea (GC) or chlamydia (CT) infection the risk of pelvic inflammatory disease is quite low (under 5%) so that shouldn't factor into insertion pain or problems. At Women's Health Practice it is very rare to have a problem dilating.....it's quick, and so little dilating really needs to be done....but we do whatever it takes, paracervical block to numb the cerivx , topical numbing, misoprostol before to soften the cervix, or really just using very tiny dilators... so if you want an IUD, discuss options with your gyno, but it is a great choice and you shouldn't be deterred by the fact that you have never had a baby.