An intrauterine device (IUD) is a highly effective, long-acting reversible contraceptive method. These small, T-shaped devices are inserted into the uterus by a healthcare provider and offer protection for several years. IUDs work by releasing hormones to thicken cervical mucus and thin the uterine lining, or by using copper to prevent fertilization and implantation. Their convenience and efficacy make them a popular choice for many seeking reliable birth control.
How IUDs are Designed to Stay in Place
IUDs are engineered to remain securely positioned within the uterus. Their T-shape, with flexible arms, allows them to conform to the uterine cavity. During insertion, the IUD is typically placed in the fundus, the uppermost part of the uterus. This ensures the arms extend outwards, resting against the uterine walls near the fallopian tubes. The uterus, a muscular organ, naturally contracts, and these contractions help keep the IUD in its intended position; while minor shifts can occur, IUDs are generally stable and stay in place for their entire lifespan.
Causes and Types of IUD Movement
Despite their stable design, an IUD can occasionally move from its optimal position. Uterine contractions, particularly strong ones during menstruation or in the first few months after insertion, are a common reason for movement. The uterus attempting to expel the device can lead to displacement. Improper insertion, where the IUD is not placed correctly in the fundus, also increases this risk.
Anatomical factors can contribute to IUD displacement, including uterine size or shape variations, fibroids, or congenital uterine anomalies that may not provide enough space. Heavy menstrual bleeding or severe cramping can also contribute to the IUD being pushed out. Movement is more likely in the first three months after insertion.
IUD displacement can manifest in several ways. Partial expulsion occurs when the IUD moves downward into the cervix but remains partly inside the uterus. Complete expulsion means the IUD has entirely exited the uterus. A rare but serious complication is uterine perforation, where the IUD pushes through the uterine wall, potentially into the abdominal cavity. This is an infrequent event, occurring in about 1 to 2 out of every 1,000 insertions.
Recognizing Signs of Movement and What to Do
Recognizing signs that an IUD might have moved is important for maintaining its effectiveness and addressing potential complications. A primary indicator of possible displacement is a change in the length of the IUD strings, which may feel shorter, longer, or even be missing. New or worsening pain, abdominal cramping, or discomfort can also signal movement. Individuals might also experience abnormal bleeding patterns, such as heavier periods, more frequent spotting, or prolonged bleeding.
Some individuals may feel the hard plastic part of the IUD at the cervix or in the vagina, or a partner might feel it during sexual intercourse. To help monitor the IUD’s position, individuals are advised to perform monthly string checks after their menstrual period. This involves washing hands, squatting or sitting, and inserting a finger into the vagina to feel for the strings.
If any of these signs are noticed, or if there is concern, contact a healthcare provider immediately. Do not attempt to adjust or remove the IUD yourself, as this could cause further displacement or injury. Use a backup method of birth control, such as condoms, until a healthcare provider can confirm the IUD’s position. Placement can be confirmed through a pelvic examination, often followed by an ultrasound.
Implications of a Displaced IUD
A displaced IUD primarily compromises its ability to prevent pregnancy. If the IUD moves from its correct position, it may no longer provide effective birth control, increasing the risk of unintended pregnancy.
Beyond reduced effectiveness, IUD displacement can lead to health complications. Individuals might experience increased pain or discomfort. There is also a potential for infection, particularly if the IUD has partially expelled or is no longer fully contained within the sterile environment of the uterus. In the rare event of uterine perforation, the IUD can cause damage to surrounding organs, which may require surgical removal and repair. A displaced IUD typically needs to be removed by a healthcare professional. Following removal, individuals can discuss alternative contraceptive methods or the possibility of inserting a new IUD with their provider.