Maybe you haven’t been on birth control in a while. Or maybe you’ve been taking a monthly, like the pill, and want something that feels less fussy. Whatever the reason might be, you’ve got a number of choices available when you decide to go on birth control — including the increasingly popular option of an intrauterine device or IUD.

So, what is an IUD? According to Dr. Mel Davis-Hall, medical director at The Lowdown, an IUD is a tiny coil T-shaped device that is primarily made of plastic and is placed into the uterus to act as contraception. There are two varieties of coil: the intrauterine device (IUD), which releases copper, and the intrauterine system (IUS), which releases a hormone known as progestogen.

Both options work to prevent sperm from fertilizing the egg and are known to be more than 99% effective. Bonus? They can last anywhere from three to 10 years, making them one of the most reliable and low-maintenance birth control methods out there.

Still, finding the birth control method that works for you and your body and lifestyle can be tricky. To help you in your decision-making process, keep reading for all the details about what you can expect when getting an IUD — from how they get it in there to whether it hurts.

What is the procedure for getting an IUD?

Before having your coil fitted, Dr. Davis-Hall says you will have a brief consultation with your general practitioner or healthcare professional, during which they may ask you to take a pregnancy test and STI test.

Then, your doctor will examine your vagina to assess the size and position of your womb and use a speculum to view the cervix, which is located at the top of the vagina.

“To make the IUD fitting procedure less uncomfortable, a local anesthetic spray may be used to numb the cervix,” Davis-Hall explains. “In some cases, a local anesthetic injection into the cervix may be used. During this time, the speculum is used to hold open the vagina. After the local anesthetic has taken effect, an instrument is used to hold the cervix while the length of the womb is measured, and the IUD/IUS is then inserted.”

Although the tube used to insert the coil is removed, the coil itself is left in place. “The IUD/IUS has two threads that hang through the neck of the womb into the vagin,” Davis-Hall explains, “and your healthcare provider may trim these for comfort.”

Does it hurt?

It depends on your pain tolerance. “Some women find getting a coil fitted to be uncomfortable or painful,” Davis-Hall says. “Don’t be afraid to ask for pain relief before your fitting. You can ask for a local anesthetic spray or gel, which is applied to the cervix before insertion.”

She also recommends eating your regular breakfast or lunch before the appointment. “Feeling nauseous, lightheaded, or faint after your coil fitting can be worse if you haven’t eaten anything,” she says. “We also recommend wearing loose, comfy clothes.”

Also, an assistant may be present during the procedure to help the healthcare professional and provide you with support, so don’t worry — you’re not alone!

Davis-Hall adds procedures of this nature may trigger a medical condition known as a “vaso-vagal response.”

“This causes a drop in blood pressure and heart rate, and you may feel nauseous, lightheaded, or even faint,” she says. “If you experience these symptoms, your healthcare provider may monitor your heart rate and blood pressure. These symptoms are short-lived, and your healthcare professional will have been trained to manage them.”

What are the benefits of an IUD?

Below, Davis-Hall outlines the benefits of the IUD:

• You don’t have to remember to take contraception every day or before sex.
• You only need to think about replacement when the time comes, which can be after 3, 5, 6, or 10 years, depending on the coil type.
• The IUD is effective as soon as it’s been fitted; the IUS can be effective immediately if inserted within the first seven days of the start of your menstrual cycle.
• The IUS can make periods lighter or stop them altogether.
• Normal fertility returns once it has been removed.
• Both are safe to use while breastfeeding.
• Neither coil is affected by other medication in the way that other forms of contraception, like the pill, might be.

What are the side effects?

Davis-Hall says some women might experience light bleeding and stomach cramps for a few days after their coil is inserted. “If you feel unwell, have bad lower tummy pain, smelly discharge, or other concerns, go back to the clinic where your coil was fitted or contact your doctor,” she cautions.

Side effects with the IUS can include acne, breast tenderness, or headaches, although Davis-Hall says these usually settle after a few months. Some women also report heavier or more painful periods when using the copper coil.