An intrauterine device (IUD) is a highly effective, long-acting reversible contraceptive placed inside the uterus to prevent pregnancy. A common question for individuals considering an IUD is whether they can continue using their preferred menstrual products, especially tampons. The answer is generally yes, as tampons are considered safe to use with a properly placed IUD. This safety is based on the distinct anatomical locations of the two products inside the body.
Understanding the IUD String
The IUD is a small, T-shaped device located high within the uterus. Tampons are inserted into the vagina, which is separated from the uterus by the cervix. The cervix acts as a barrier, preventing the tampon from entering the uterine cavity where the IUD sits.
Two thin plastic threads are attached to the IUD and extend through the cervical opening, resting in the upper vagina. These strings are typically trimmed to curl around the cervix. The main concern is the possibility of the tampon catching the strings during removal and pulling the IUD out of place. However, the risk of tampon use causing IUD displacement or expulsion is very low.
Timing and Technique for Tampon Use
While tampons are safe with an IUD, internal menstrual products should be avoided immediately after insertion. Healthcare providers often recommend avoiding tampons for at least 24 to 48 hours following IUD placement to minimize the risk of infection. Some practitioners advise waiting until after the first follow-up appointment, typically four to six weeks after insertion, to ensure the IUD has settled.
A specific technique for removal can help mitigate the risk of snagging the IUD strings. Always ensure the tampon is fully saturated with menstrual fluid before removal, as a dry tampon creates friction. Pull the tampon string gently and straight out, avoiding an upward or angled pull that could catch the IUD strings resting near the cervix. Using the lowest necessary absorbency tampon also helps prevent excessive dryness upon removal.
Alternative Menstrual Products
Other menstrual products have different risk profiles when used with an IUD. Menstrual pads or period underwear are the safest options since they are external and have no contact with the IUD strings or the internal environment. Many people successfully use menstrual cups or discs, but these products require different considerations.
Menstrual cups and discs create a suction seal against the vaginal walls to collect fluid. Evidence suggests concurrent menstrual cup use may be associated with a slightly increased rate of IUD expulsion compared to tampon or pad use. If using a cup, you must break the seal by pinching the cup or inserting a finger along the side before removal. Failing to release this suction could tug on the IUD strings, increasing the risk of dislodgement.
Monitoring IUD Placement
Checking the IUD strings regularly is the primary way to monitor device placement. You should perform a self-check after each menstrual period, as the device is most likely to move during this time. Begin by washing your hands and inserting a clean finger into the vagina until you feel the firm, rubbery texture of the cervix.
The IUD strings should feel like one or two pieces of thin fishing line extending from the cervix. If the strings feel noticeably longer, shorter, or if you cannot feel them at all, the IUD may have shifted. Contact your healthcare provider immediately if you feel the hard plastic or copper of the IUD itself, or if you experience severe cramping or unusual bleeding, as these are signs of possible displacement or expulsion.