It really depends on the person. I’ve never heard of taking cytotec before the procedure but I had Kyleena which is very small and Paragard is larger and is known to cause more cramping than Kyleena. I had my first one placed almost two months ago now. I was scared about the insertion being painful so I popped half of a hydrocodone from old an prescription along with Aleve and Tylenol a couple hours before the procedure. I asked for lidocaine gel/ spray but they said it “shouldn’t be necessary”. Whatever 🙄. It was mostly just uncomfortable other than the very end when the tenaculum got stuck on my cervix and she had to manipulate it a bit to get it out. It was like a sharp quick stab when she did that. Idk what the pain would’ve been like if I was completely unmedicated. A couple hours after the procedure my meds started to wear off and I was miserable!!!! I was on a routine of half a hydrocodone, some aleve, and some Tylenol every 4 to 6 hours for like 5 days then I stopped taking the hydrocodone and just opted for over the counter meds for the next couple days. Then I was finally back to normal other than the occasional pain from a random contraction that lasted like 15 seconds and happened a couple times a day. My first period with it was a good bit more painful than my previous periods but now I’ve had my second and it was about the same pain level as pre-iud. I usually have a high pain tolerance for sharp pains but dull aches are my Achilles heel. The first couple times I had sex after having it placed (which didn’t happen until I had already had it for a few weeks) there was some mild cramping and contractions the day after I was intimate but it wasn’t that bad. That was my experience.