I just got one in for the first time at GW MFA and the doc suggested the numbing shots - I didn't know that was even an option and man oh man did she save me from a world of hurt. She said always ask for the shot while you're making the appointment and if they say no, bail. She also said take ibuprofen before going, otherwise they'll give you some and wait for it to kick in before administering the numbing shot and inserting the iud. they were also great about giving me time to just sorta veg out while the shot wore off.