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What causes the cramping after sex since the insertion of a ParaGard IUD? #926/9
I'm actually asking this for my girlfriend because I'm getting a bit worried. She had a Paragard IUD implanted (inserted) about two weeks ago. Over those two weeks, she has had a fair amount of spotting and cramping. I understand this is normal, except the cramping, I haven't read anything about that. Anyways, after reading a lot, it seems to be a semi-normal reaction. BUT, what worries me is that the cramping is happening after we have sex. We did wait to have sex for about 10 days, as per the instructions from the doctor.

Okay, so my question is this; we had sex yesterday and she has cramping today. She is in a fair amount of pain. Is this normal? How long is cramping normal and when should I be worried enough about it to call the doctor.

Thank you in advance.

First of all, I always appreciate men who play an important part in contraceptive choice, use, payment or management of problems.  So, thank you!


Spotting and cramping/pain are fairly common in the weeks after ParaGard IUD insertion.  The cramping after intercourse yesterday might be explained to uterine contractions at the time of or after intercourse.  Did she have an orgasm?  An orgasm can cause cramping.



His reply on 9-25:  “Thank you very much for that fast reply!  I thought I’d have to wait a while, really…thank you!”


“This is good to know.  I knew the spotting could last up to 4-6 weeks, but I hadn’t ready anything about cramps.  Is there any idea how long that can last?  And yes, she did have an orgasm.  We were thinking that’s what happened, but uterine contractions aren’t really in our vocabulary. I should have mentioned this in the first question, but I guess I forgot.  The cramping actually started this morning, not last night after intercourse.  The same thing happened a couple of days ago when we first had intercourse after the insertion of the IUD.  The reason I mention this is because it just seems a bit odd to me that the cramping would start 8 hours later.  I guess that is the problem, I am just being a bit over protective.”


“One last thing; is the cramping dangerous?  Should we wait to have sex until everything is healed up? I don’t know if it is possible, but I don’t want her to get cramps that make her expel the IUD.  I suppose we’ll just try to her a follow up appointment a bit sooner.”


“Thanks again.”


What you might do for several days is “outercourse”.  Regular vaginal intercourse would not be dangerous, but having sex outside the vagina for a week or part of a week might help.




Key Words:  ParaGard IUD, spotting, cramping, sex, pain, uterine contractions, intercourse, orgasm, outercourse, vagina


Robert A. Hatcher MD, MPH
Emeritus Professor of Gynecology and Obstetrics
Emory University School of Medicine
Atlanta, GA

The directors and owners of this website and any publications and information concerning health matters offered here advise a person with a particular problem to consult a primary-care clinician or a specialist in obstetrics, gynecology, or urology (depending on the problem or the contraceptive) as well as the product package insert and other references before diagnosing, managing, or treating the problem.
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