An intrauterine device (IUD) is a highly effective form of birth control, offering long-term pregnancy prevention by being placed inside the uterus. While designed to remain in place, the IUD can become displaced, sometimes appearing “stuck” in the cervix.
Understanding IUD Displacement
When an IUD is described as “stuck” in the cervix, it refers to displacement from its intended position high in the uterus. This can be a partial expulsion, where the device moves into the cervical canal, or an embedment, where part of the IUD penetrates the uterine wall or cervical tissue. Other forms of displacement include complete expulsion (where the device fully exits the body) or uterine perforation (where the IUD pierces the uterine wall). Displacement to the lower uterine segment or cervix can reduce the IUD’s effectiveness.
Factors Contributing to Displacement
Several factors can contribute to an IUD becoming displaced. Improper insertion technique can increase the likelihood of the IUD shifting.
Uterine anatomy, such as a small uterine cavity or conditions like uterine fibroids, can also affect the IUD’s ability to remain in place. Strong uterine contractions, particularly during menstruation, may cause the IUD to be pushed downwards.
Displacement is more likely to occur during the first few months after insertion. Insertion immediately after childbirth can also increase the risk of displacement or expulsion.
Recognizing Signs of Displacement
Signs of IUD displacement include a change in the length of the IUD strings: they might feel shorter, longer, or entirely missing. New or worsening pain and cramping can also signal a problem. Other symptoms include abnormal bleeding or spotting between periods, or a change in menstrual flow. Some individuals may experience pain during intercourse, or their partner might feel the IUD’s hard plastic. In some instances, a person might even feel the IUD protruding from the cervix.
Medical Intervention for Displacement
If an IUD is suspected to be displaced, medical intervention is necessary. Healthcare providers typically begin with a pelvic examination to assess the IUD strings and cervix. An ultrasound is commonly used to determine the IUD’s position within the uterus or if it has moved into the cervical canal or elsewhere.
If the IUD is displaced but its strings are visible, the provider may attempt removal by gently pulling the strings with specialized forceps. For IUDs that are embedded or not easily accessible, procedures like hysteroscopy (for direct visualization and removal) or even laparoscopy (in rare cases of uterine perforation) may be required. Attempting to remove or reposition a displaced IUD without professional medical assistance is not advised due to potential complications.
Monitoring and Prevention
Regular monitoring helps detect potential IUD displacement early. Users are advised to perform monthly self-checks for the IUD strings, typically after their menstrual period. Feel for the strings and note any changes in their length or presence. Attending follow-up appointments after insertion, usually within the first few weeks, allows a healthcare provider to confirm the IUD’s correct placement.
While not all displacements can be prevented, consistent self-monitoring and professional check-ups can lead to early detection, aiding in maintaining contraceptive efficacy. If any concerns arise, contact a healthcare provider promptly for evaluation.