Intrauterine devices (IUDs) are effective, long-lasting contraception. While generally safe, IUD movement and discomfort can occur. This article explores IUD placement, reasons for shifting, symptoms, and when to seek medical advice.
Understanding IUD Positioning
An IUD is a small, T-shaped device inserted into the uterus for pregnancy prevention. It is placed through the vagina and cervix, resting near the top of the uterus (fundus).
The IUD’s arms unfold laterally, securing its position. Two thin strings, 1 to 2 inches long, extend through the cervix into the vagina for self-checks and removal. The uterus is a muscular organ, which generally contributes to the device’s stability once properly situated.
Reasons for IUD Shifting
IUDs are generally stable, but movement can occur. Strong uterine contractions, like those during menstruation, can dislodge the device. Improper initial placement can also make it prone to shifting.
Uterine size or shape variations, such as fibroids, can affect IUD fit. If the uterus is too small, the body may attempt expulsion. Movement is most likely within the first three months after insertion. Rarely, an IUD can perforate the uterine wall, a serious but uncommon complication (about 1 in 1,000 insertions), potentially migrating into the abdominal cavity. Insertion shortly after childbirth or during lactation can increase perforation risk.
Recognizing Symptoms of IUD Movement
Identifying symptoms of IUD movement is important for prompt medical attention. New or worsening pelvic pain and cramping, distinct from typical menstrual cramps or initial discomfort, can indicate a shifted IUD. This pain might be persistent, severe, or not relieved by over-the-counter medications. Pain during sexual intercourse could also be a symptom.
Changes in menstrual bleeding patterns are another sign. This may include heavier or longer periods, irregular bleeding, or spotting between cycles, especially if you previously had a lighter flow with a hormonal IUD.
The inability to feel the IUD strings, or noticing they feel shorter or longer than usual, suggests the IUD may have moved. In some instances, a person or their partner might feel the hard, plastic part of the IUD itself, which should not be palpable when correctly positioned.
Other potential symptoms include unusual vaginal discharge, fever, or chills, which could indicate infection. If an IUD is no longer effective due to movement, symptoms of pregnancy might also arise.
When to Consult a Healthcare Provider
If you suspect your IUD has moved or you experience any concerning symptoms, consult a healthcare provider promptly. Do not attempt to adjust or remove the IUD yourself, as this can cause further displacement or injury.
Your healthcare provider will perform a pelvic exam to check IUD strings and assess for displacement. An ultrasound (transabdominal or transvaginal) confirms IUD position. If ultrasound fails, an X-ray of the abdomen and pelvis may be performed.
If movement is confirmed, options include IUD removal. A new IUD can often be inserted during the same appointment. Use backup contraception, like condoms, until position is confirmed or a new method is in place.