1. Uterine cramping is common after IUD placement. You can help relieve the discomfort with heating pads, Tylenol (acetaminophen), Aspirin or Advil (ibuprofen). If your cramping becomes very painful, please call the office.

2. Irregular bleeding and spotting is normal for the first few months after the IUD is placed. In some cases, women may experience irregular bleeding or spotting for up to six months after the IUD is placed. This bleeding can be annoying at first but usually will become lighter with the progesterone containing IUD.

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3. Your period may be heavier and longer with the Paragard IUD.

4. IUDs do not protect against sexually transmitted infections including the AIDS virus (HIV), warts (HPV), gonorrhea, Chlamydia, and herpes.

5. After insertion we suggest you use condoms till your follow up visit to check the IUD position.

6. It is possible for the IUD to come out of the uterus. If it does slip out of place, it is most likely to happen in the first few weeks after being put in. Symptoms can be worsening pain/cramps or a sudden increase in bleeding. If you think the IUD has slipped, CALL THE OFFICE.

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7. Keep your follow-up appointment for 4-6 weeks after the IUD has been placed, for a string check.

8. Pregnancy is unlikely after IUD placement, but can happen. If you have early pregnancy symptoms like nausea and vomiting, breast tenderness, frequent urination or abdominal pain, you can take a pregnancy test. Please call if your pregnancy test is positive.

9. The IUD should only be removed by a healthcare provider. IT SHOULD NOT BE LEFT IN LONGER past the recommended time as told to you by your doctor; and written on the card given to you at the time of insertion.

POST-OPERATIVE INSTRUCTIONS 1. For the next ONE week, do not insert anything into your vagina. This includes tampons, douching, and sexual intercourse.

2. Resume usual activities after leaving today.

3. You may shower. Avoid hot tubs or swimming for one week.

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4. You may have mild cramping in your lower abdomen for one to two days. You may take Ibuprofen such as Advil, Motrin, Aleve or Tylenol if you are not allergic to it. Please follow the instructions on the bottle. Use ibuprofen 200 mg, 2 tablets every 4 hours as needed for severe cramps. Do not use ibuprofen if you are allergic to aspirin.

5. You may have some dark or bright red spotting/discharge for one to two days. This may last for up to one week. Use pads only (no tampons). Do not be alarmed if your period is off-schedule this month.

PLEASE CALL THE OFFICE for:

1. Bleeding heavier than menses, filling one pad or more an hour for 2 hours in a row.

2. Persistent severe pain or cramping after 72 hours.

3. Foul vaginal discharge.

4. Temperature greater than 100.4 degrees.

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