How bad does an IUD (Mirena) hurt?

It's not that bad at all. You definitely don't need dilaudid. My GYN told me to take 2 OTC pills beforehand and that was all I needed, if even that. There is a feeling of pressure, but not much else. My GYN gave me a cervical block since I've never had kids either, so I didn't feel much, plus its a quick process, so there is no need for drugs like dilaudid. After I got mine put in I went back to grad school for a full day of classes with no problems.