An intrauterine device (IUD) is a highly effective form of long-acting reversible contraception inserted into the uterus by a healthcare provider. This small, T-shaped plastic device offers protection against pregnancy for several years, but it must eventually be removed. IUDs are medical devices that require removal only by a trained healthcare professional in a clinical setting.
The Dangers of Attempting Self-Removal
Trying to remove an IUD without medical training exposes the reproductive system to several serious physical risks. The most immediate risk is the high probability of an incomplete removal, where the IUD is dislodged from the uterine wall but only partially exits the cervix or remains incorrectly positioned. If only part of the device is removed, the IUD is no longer effective at preventing pregnancy and can cause significant pain and cramping.
The IUD’s flexible arms anchor it within the uterus and require a specific gentle technique to fold them upon exit. Applying uncontrolled force can lead to uterine damage, including cervical tearing or, in rare cases, perforation of the uterine wall. These internal injuries can result in heavy bleeding and necessitate emergency medical intervention.
Manipulating any medical device inside the body without sterile tools carries a high risk of introducing bacteria into the pelvic cavity and uterus. This greatly increases the chance of developing a severe infection, which could lead to pelvic inflammatory disease or even sepsis, a life-threatening systemic response. Furthermore, non-professional pulling can cause the thin IUD strings to break, leaving the device stuck and requiring a more complex retrieval procedure.
Understanding the Role of IUD Strings
The thin, plastic strings that extend from the IUD down through the cervix into the vagina are often why people consider self-removal, but they serve two primary purposes. They allow the patient to perform monthly checks to confirm the IUD remains correctly in place within the uterine cavity. Most importantly, they serve as the handle a clinician uses to perform a safe and controlled removal.
The strings are deliberately thin and are not designed to withstand the force required to safely collapse the IUD arms for passage through the cervical canal. Improper pulling can cause the strings to snap off at the cervix, leaving the IUD behind. This necessitates the use of specialized tools, such as a cytobrush or an IUD hook, to locate the strings or the device within the cervical canal or uterus.
What to Expect During Professional IUD Removal
Professional IUD removal is a fast, routine procedure performed in a healthcare provider’s office and is typically less uncomfortable than insertion. Patients may be advised to take an over-the-counter non-steroidal anti-inflammatory drug (NSAID) like ibuprofen about an hour before the appointment to minimize cramping. Removal can be done at any point during the menstrual cycle, though some providers prefer to time it during menstruation when the cervix is naturally softer and more open.
The clinician first inserts a speculum into the vagina to gently open the walls and gain a clear view of the cervix, similar to a standard pelvic exam. They then locate the IUD strings protruding from the cervical opening. Using a specialized sterile tool, such as long forceps, the provider grasps the strings firmly.
The provider applies slow, steady, outward traction on the strings. This controlled pull causes the flexible arms of the IUD to fold upward, allowing the device to pass safely through the narrow cervical canal. The entire removal process usually takes only a few seconds or minutes.
Following the procedure, patients may experience mild cramping or light spotting for a few hours or days. If the IUD was used for contraception, fertility returns immediately after removal. Patients not wishing to become pregnant should discuss alternative birth control methods with their provider and begin using them immediately to ensure continuous protection.