For individuals seeking reliable contraception, intrauterine devices (IUDs) are a popular choice, while menstrual cups offer a reusable and environmentally friendly option for managing periods. A common question arises for those who use both: can a menstrual cup dislodge an IUD? This article explains how these products interact and offers practical advice.
Understanding IUDs and Menstrual Cups
Intrauterine devices are small, T-shaped birth control devices inserted into the uterus by a healthcare provider. They are a form of long-acting reversible contraception (LARC) and can prevent pregnancy for several years, depending on the type. IUDs work by creating an environment in the uterus that is inhospitable to sperm, preventing fertilization or implantation. There are two main types: hormonal IUDs, which release progestin, and copper IUDs, which are hormone-free. Both types have one or two thin plastic strings that extend from the IUD through the cervix and into the upper part of the vagina, allowing for removal by a healthcare professional.
Menstrual cups are flexible, bell-shaped devices, typically made of medical-grade silicone or rubber, inserted into the vagina to collect menstrual fluid. Unlike tampons or pads that absorb fluid, menstrual cups collect it, forming a seal against the vaginal walls to prevent leaks. They are reusable and can be worn for up to 12 hours, depending on the flow. The cup sits lower in the vaginal canal than a tampon, usually below the cervix.
The Mechanics of Potential Dislodgement
The primary concern regarding menstrual cup use with an IUD centers on the suction created by the cup and the presence of the IUD strings. When a menstrual cup is inserted, it forms a seal with the vaginal walls, creating a vacuum that helps it stay in place and prevent leaks. During removal, if this seal is not properly broken, the suction can exert a pulling force. This force could potentially tug on the IUD strings, which typically hang a few centimeters into the vagina, or even directly on the IUD itself if positioned too high.
While theoretically possible, IUD expulsion due to menstrual cup use is rare. IUDs are designed to remain securely in place within the uterus. However, some studies suggest a potential association, with higher expulsion rates reported among menstrual cup users compared to non-users or tampon users. IUD expulsion can also occur independently of menstrual cup use, with rates generally ranging from 0.05% to 8% in the first year, and is more common in the first few months after insertion or during a period.
How to Use a Menstrual Cup Safely
Minimizing the risk of IUD dislodgement while using a menstrual cup involves specific techniques during insertion and removal. The most important step is to always break the suction seal before attempting to remove the cup. This can be done by gently pinching the base of the cup or pressing on its side to release the vacuum, allowing for a smooth and controlled removal. Pulling the stem without breaking the seal can create strong suction against the cervix and potentially pull on the IUD strings.
Ensuring proper positioning of the menstrual cup is also important. The cup should sit lower in the vaginal canal, below the cervix, and not directly adjacent to it. Aiming the cup towards the base of the spine during insertion, rather than straight up, can help achieve this lower placement. Regularly checking your IUD strings, as advised by your healthcare provider, helps ensure the IUD remains in its correct position. If there are any concerns about IUD placement or menstrual cup use, consulting a healthcare provider is always recommended for personalized guidance.
What to Do if You Suspect IUD Displacement
Recognizing the signs of IUD displacement or expulsion is important for continued contraceptive effectiveness and health. Changes in IUD string length, such as feeling them shorter or longer than usual, or being unable to feel them at all, can indicate movement. Other potential signs include feeling the hard plastic part of the IUD itself, experiencing unusual or severe abdominal pain and cramping, or noticing heavier or atypical vaginal bleeding. Some individuals might also experience unusual vaginal discharge or pain during sexual activity if the IUD has moved.
If any of these signs occur, it is important to contact a healthcare provider immediately. Do not attempt to reinsert the IUD yourself, as this can cause injury or introduce infection. Until a healthcare professional confirms the IUD’s position and effectiveness, it is advisable to use an alternative or backup method of contraception, such as condoms, to prevent unintended pregnancy. A doctor can perform an examination and possibly an ultrasound to determine if the IUD has moved and discuss the appropriate next steps.