Intrauterine devices, commonly known as IUDs, are small, T-shaped contraceptive devices inserted into the uterus by a healthcare provider. These devices offer highly effective, long-acting reversible birth control, lasting for several years depending on the type. A key component of an IUD is its string, which extends from the device through the cervix into the vagina. Many people wonder if these strings can break off, which is a common concern when they cannot feel them.
The Purpose of IUD Strings and Why They Might Seem Gone
IUD strings are thin plastic threads. Their primary purposes are twofold: allowing individuals to self-check that their IUD remains in place and enabling a healthcare provider to safely remove the device. Actual breakage is rare; the strings are durable and not prone to snapping under normal conditions.
More commonly, strings might seem “gone” for several reasons that do not involve breakage. Sometimes, the strings curl up or coil inside the cervix or uterus, making them difficult or impossible to feel during a self-check. This can also happen if the strings were cut very short during the initial insertion procedure. Another possibility, though less frequent, is that the IUD itself has partially or fully expelled from the uterus, taking the strings with it. Up to 18% of people with an IUD report being unable to find their strings at some point.
What to Do If You Cannot Feel Your IUD Strings
If you cannot feel your IUD strings, first attempt a careful self-check. Begin by washing your hands to prevent infection. Then, squat or sit in a comfortable position and insert your index or middle finger into your vagina until you can feel your cervix, which often feels firm like the tip of your nose. Gently feel around the cervix for the thin, fishing-line-like strings.
If the strings remain unfelt, or if they feel shorter or longer than usual, contact a healthcare provider. Until your appointment, use a backup method of contraception, such as condoms, to prevent unintended pregnancy, as the IUD may no longer be effective if it has shifted. Avoid pulling on the strings if found, as this could dislodge the IUD. Seek immediate medical attention if you experience symptoms like severe cramping, abnormal discharge or odor, fever, chills, or signs of pregnancy.
Professional Management of Missing IUD Strings
When a patient reports missing IUD strings, a healthcare provider begins with a pelvic examination. During this exam, a speculum is used to visualize the cervix, allowing the provider to look for the strings directly. If the strings are not immediately visible, the provider may use specialized tools like a cytobrush or cotton swab to gently sweep the cervical canal, attempting to bring any retracted strings into view. A colposcope may also be used for better visualization.
If these methods are unsuccessful, a transvaginal ultrasound is often performed to confirm the IUD’s presence and exact location within the uterus. This imaging technique can determine if the IUD is still in place, has shifted, or has been expelled. If the IUD is not found with an ultrasound, it may indicate the device has been expelled without the individual noticing. If the IUD is in place but strings are inaccessible or embedded, procedures like hysteroscopy may be considered for removal. Even if strings are missing, the IUD can almost always be safely removed by a medical professional.