An intrauterine device (IUD) is a small, T-shaped piece of flexible plastic inserted into the uterus for long-acting reversible contraception. Both hormonal and copper IUDs are highly effective at preventing pregnancy. Removal is a medical procedure that should only be performed by a trained healthcare professional. Attempting self-removal carries significant risks and serious complications, making a scheduled appointment the only safe course of action.
Why Attempting IUD Removal Yourself Is Dangerous
The primary danger of self-removal is uterine perforation, which occurs when the IUD or the force used creates a hole in the uterine wall. This complication can cause internal bleeding, damage to other organs, and often requires emergency surgery. Improper pulling can also cause the IUD to dislodge without fully coming out, a condition known as partial expulsion.
If the IUD is only partially removed or breaks, remaining pieces can become embedded in the uterine lining. Retrieving these fragments requires specialized tools and sometimes a surgical procedure called a hysteroscopy. Introducing non-sterile objects or unwashed hands into the vagina and cervix significantly increases the risk of introducing bacteria.
This introduction of bacteria can lead to a serious upper genital tract infection called Pelvic Inflammatory Disease (PID). PID can cause chronic pelvic pain and, if left untreated, lead to long-term issues like infertility or ectopic pregnancy. Applying inappropriate force or angle to the strings can also cause trauma to the cervix or uterine lining, resulting in severe pain, cramping, and excessive bleeding.
The Anatomy and Purpose of IUD Strings
The IUD strings are thin, durable plastic threads attached to the base of the T-shaped device within the uterus. When inserted, these strings are trimmed to extend about one to two inches into the upper vagina, resting against the cervix. The strings’ main function is to allow the user to check that the IUD is still correctly positioned.
The strings also serve as the mechanism for professional removal, but they are not designed for patient use in pulling the device out. The IUD is secured high inside the uterine cavity, where the T-shaped arms are unfolded to hold it in place. The strings merely provide a point of controlled contact for a healthcare provider.
The material of the strings is thin and flexible, and they are not strong enough to withstand the force required to safely collapse the IUD arms and pull the device through the cervix without complications. Pulling with excessive force or from a non-optimal angle can cause the device to tilt, break, or become lodged.
How Healthcare Providers Safely Remove an IUD
Professional removal is quick, typically taking only a few minutes, and is performed in a sterile setting to minimize infection risk. The patient is positioned similarly to a routine pelvic exam. A speculum is inserted to open the vaginal walls and allow the provider clear visualization of the cervix. The provider then cleans the cervix with an antiseptic solution.
Once the cervix is visible, the provider locates the IUD strings protruding from the cervical opening. They use specialized, sterile forceps, such as ring forceps, to grasp the strings firmly. The provider then applies steady, gentle traction directly downward.
This controlled pull causes the flexible arms of the T-shaped IUD to fold upward, allowing the device to pass through the cervical canal and into the vagina. The provider inspects the removed IUD to ensure it is intact and that no pieces remain inside the uterus. If the strings are not visible, the provider uses tools like a cytobrush or a special IUD hook to safely locate them within the cervical canal.
Signs of Complications Requiring Immediate Care
If you have attempted self-removal or suspect an issue with the IUD’s placement, certain symptoms warrant immediate medical attention. Severe, sharp, or persistent abdominal or pelvic pain that does not resolve with over-the-counter pain relievers can signal uterine trauma or perforation. Excessive vaginal bleeding is also a serious concern, defined as soaking through more than one large sanitary pad per hour for two or more consecutive hours.
Signs of a possible infection, such as Pelvic Inflammatory Disease, require prompt evaluation. These symptoms include an unexplained fever or chills, along with an unusual or foul-smelling vaginal discharge. If the IUD strings suddenly feel significantly shorter or longer than usual, or if you cannot feel them at all, this may indicate the IUD has moved and requires a professional ultrasound to confirm its location.