The insertion for me was yes, the most pain I've ever experienced (even so I have many tattoos). I blame my doctor for not telling me what was involved. Got it Thursday and I don't think I should have. I read these posts and had a breakdown. My period on the pill was a breeze, short, light, and cramp free. I still have light cramping which I don't appreciate and if I have spotting that never ends from this period I want it out. But if so this time I want to be prepared for the pain! Assuming there would be like the insertion or worse.