Alternative Factors for Discomfort Following IUD Placement Beyond Misalignment
I have a peculiar inquiry that I'm grappling with, and I'm unsure where to turn. At 27 years old, I underwent the insertion of a Mirena IUD in September 2024. Initially, I didn’t think much of it when I began to notice unexpected pain and cramping around November. However, by December, I encountered severe discomfort during orgasm. After having an ultrasound in January, it became clear that my IUD had shifted slightly from its intended placement. I then had it replaced, which alleviated the pain completely. In May 2025, due to separate hormonal concerns, I opted for the removal of the Mirena IUD. After researching and discussing with my healthcare provider, I determined that Kyleena might be a more suitable alternative with potentially fewer hormonal side effects since it has a lower progesterone dosage. I received the Kyleena IUD in July without any complications for approximately three weeks. Currently, I find myself facing similar cramping and pain that has persisted for about two weeks, leading me to suspect another potential shift in the IUD that would necessitate replacement. An ultrasound was conducted, and my physician has reported that the scan did not indicate any irregularities or misalignment of the device. Though I'm clearly experiencing discomfort, I remain uncertain about its source. What could be causing this if the IUD appears to be correctly positioned? To provide additional context, the pain I’m experiencing is more akin to a sharp, stabbing sensation rather than typical cramping. While there are moments of cramping comparable to menstrual discomfort, I also notice pain when sitting—which is unusual for me during my period. Interestingly, the recent onset of discomfort tends to occur right after intimacy, although it gradually subsides within an hour. Prior to having an IUD, I had never encountered pain during intercourse. As the situation has developed, I’ve noted that the discomfort is primarily located on the left side. During my latest internal ultrasound, the technician examined my ovaries, and scanning the left one was particularly uncomfortable and somewhat painful. This raised my suspicion that the IUD might be tilted towards that side, but the ultrasound results suggest otherwise. In previous IUD insertions, my doctor has remarked that my cervix is "positioned quite far back," requiring the use of different speculums for enhanced visibility. I wonder if this detail could be relevant, as I’m starting to contemplate whether the shape or size of my uterus is contributing to this pain. At this point, any insights or suggestions would be immensely appreciated. Thank you for taking the time to consider my situation.
Answers (1)

8/26/2025, 8:33:42 PM
OpenHealth AI
It sounds like you’re going through a challenging experience with your IUD, and it’s understandable to seek clarity about your discomfort. While your ultrasound indicates that the Kyleena IUD is positioned correctly, and since you’re still experiencing sharp pain, it could be related to several factors apart from misalignment of the device itself.
Key Points:
- IUD-related pain may not always be linked to its position.
- Other causes of pain may involve pelvic or ovarian issues.
- Anatomical factors, such as cervical positioning, may contribute to discomfort.
Explanation:
The discomfort you're experiencing can stem from various causes, even if the IUD is confirmed to be properly positioned. Some potential factors include:
- Hormonal Fluctuations: Even a low-dose hormonal IUD like Kyleena can cause side effects as your body adjusts, which may result in sensations of sharp pain or cramping.
- Pelvic Inflammatory Conditions: Conditions like ovarian cysts or endometriosis can lead to pain, especially if they involve the left side of your pelvis, correlating with your symptoms after intimacy.
- Cervical Sensitivity or Anatomy: Given that your cervix is positioned further back, it may affect how the IUD interacts with the pelvic structures and can lead to discomfort during activities like intercourse.
- Muscle Tension: Pelvic muscle tension or spasm can also contribute to sharp pain, especially if it coincidentally arises after intimacy.
Next Steps:
- Track Your Symptoms: Maintain a diary noting when the pain occurs, its intensity, and any other accompanying symptoms. This information can help identify triggers and provide useful data for your healthcare provider.
- Consider Self-Care: To manage discomfort at home, apply heat (like a heating pad) to the lower abdomen, and practice relaxation techniques to reduce muscle tension.
- Consultation Review: While you’ve had imaging done, if the pain persists, consider discussing with your healthcare provider the possibility of further evaluations for conditions like endometriosis or ovarian cysts, especially since the pain is unilateral and persisting.
- Communication with Your Provider: Share your concerns about anatomical factors and how that might relate to your pain experience. They may have additional testing or adjustments to suggest based on your unique anatomy.
Please remember, your experience is important, and seeking answers is a crucial part of feeling better. If the pain changes significantly in intensity or you experience new symptoms (like fever or abnormal bleeding), don’t hesitate to reach out for further assistance.
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