The IUD must be placed by a doctor or nurse, who will ensure it is correctly positioned. Occasionally, muscle contractions during menstruation can push it out of place or expel it, and very rarely it can perforate the wall of the uterus. If you experience any unusual bleeding, pain or discomfort, you should consult your doctor or nurse as soon as possible. 

An IUD can be left in place for up to 5 or 10 years. After this time, it will need to be replaced with a new device. If this method of contraception has worked well for you in this time, you can discuss continuing with the IUD with your doctor or nurse. 

It is recommended to use sanitary pads. If you do use tampons, they should be changed more frequently and care should be taken not to pull the threads of the IUD when manipulating the tampon. 

Neither you nor your partner should feel the IUD during sexual intercourse. If you do, you should avoid having sex until your doctor or nurse has checked that the IUD is still in the correct position. 

For many women, the cramps go away relatively quickly. But for others, they may last longer. Cramps should gradually decrease in severity but may continue on and off for the first few weeks after placement. Within the first three to six months, they should subside entirely.