Intrauterine devices (IUDs) are a highly effective form of birth control, offering over 99% protection against pregnancy. Many IUD users wonder if the small strings extending from the device can move. Understanding the nature of IUD strings and expected changes is helpful for anyone using this contraceptive method.
What Are IUD Strings?
IUD strings are thin, flexible threads attached to the base of the T-shaped device. Made from soft plastic or nylon, they extend through the cervix into the upper vagina after insertion. Their primary purpose is to allow a healthcare provider to easily remove the IUD for replacement or when contraception is no longer desired. The strings also help individuals self-check that the IUD remains in its correct position.
Why Strings May Seem to Move Normally
It is common for IUD strings to feel as though they have changed position or length, even when the IUD is properly situated. This perceived movement is often due to natural physiological changes. The cervix changes its position throughout the menstrual cycle. During menstruation, the cervix typically sits lower, making strings feel longer. Conversely, at other times, the cervix may be higher, making the strings feel shorter or more difficult to locate.
Other benign factors can also influence how the strings are perceived. Vaginal muscles can contract and relax, and different body positions can temporarily affect the perceived length or location. Sometimes, the strings may simply curl up against the cervix or become hidden in a fold of vaginal tissue, making them harder to feel. These normal variations do not indicate a problem with the IUD’s placement or effectiveness.
Signs That String Movement Is a Concern
While some string movement is normal, certain changes can indicate that the IUD has shifted or been expelled. It is concerning if the strings feel significantly longer or shorter, or if they are entirely absent when you check for them. Feeling the hard plastic part of the IUD poking out of the cervix is a clear sign that the device has moved.
In addition to string changes, other symptoms can suggest a problem. These include new or worsening pain, severe cramping, unusual vaginal discharge, or irregular and heavy bleeding. If a hormonal IUD user experiences a return of heavy periods after they had become lighter, or if a copper IUD user notices unusually light menstruation, this could also be a sign of displacement. Such symptoms, especially when combined with noticeable string changes, warrant immediate medical attention.
How to Check Your IUD Strings
Regularly checking your IUD strings helps you become familiar with what is normal for your body and identify any concerning changes. It is recommended to check them once a month, often after your period, as the cervix is typically lower and the strings may be easier to find. Begin by washing your hands thoroughly with soap and water to prevent infection. Find a comfortable position, such as sitting, squatting, or standing with one leg raised.
Gently insert your index or middle finger into your vagina until you feel your cervix. The cervix feels firm and rubbery, similar to the tip of your nose. From the center of your cervix, you should feel one or two thin, flexible strings. Do not pull on the strings; simply feel for their presence and assess their length relative to what you normally expect. Consistent self-checking helps you learn the typical feel and position of your strings.
Next Steps If You Notice Changes
If you detect any concerning changes in your IUD strings, such as them feeling significantly longer or shorter, or if you cannot feel them, contact a healthcare provider promptly. This also applies if you experience symptoms like sharp cramps, unusual bleeding, or discharge. Until examined, use a backup method of birth control, such as condoms, or avoid sexual intercourse to prevent unintended pregnancy.
Do not attempt to adjust or remove the IUD yourself, as this can lead to complications. Your healthcare provider can perform an examination, and if necessary, use imaging tests like an ultrasound to confirm the IUD’s position. If the IUD has moved, they will safely remove it and discuss options for replacement or alternative contraception.