An intrauterine device (IUD) is a small, T-shaped form of long-acting, reversible contraception placed inside the uterus by a healthcare provider. The device, which can be made of plastic and release hormones or contain copper, is highly effective at preventing pregnancy for several years. The wearer should not feel the T-shaped device itself, but the thin strings attached to the IUD are a separate consideration.
The Device Itself: Internal Sensation
The IUD is designed to sit high inside the uterine cavity, which is a muscular organ located beyond the cervix. The uterus, particularly the upper section where the IUD rests, has very few sensory nerve endings, which is the primary reason the wearer typically does not feel the device during daily activities. The small size of the IUD also means it takes up little space within the uterus, allowing the wearer to go about their routine without any internal awareness of the device.
If the hard plastic or copper frame of the IUD is felt internally, it generally suggests the device has shifted from its correct position. The sensation of the IUD itself is highly unusual and often indicates a problem, such as a partial expulsion where the device has slipped down into the cervix. When the IUD is correctly positioned, it should remain completely unnoticed.
The Strings: Partner Sensation During Intercourse
The only part of the IUD that extends outside the uterus is a pair of thin, plastic strings or threads. A clinician trims these strings during insertion so they hang a short distance, typically one to two inches, into the upper part of the vagina. These strings are essential for self-monitoring and for allowing a healthcare provider to remove the device later.
While the wearer generally cannot feel the strings, a sexual partner might occasionally notice them during penetrative intercourse. The strings are described as feeling like fine hair or a piece of fishing line, and for most couples, they do not cause discomfort. Over time, the strings tend to soften and curl slightly around the cervix, which helps to minimize any sensation.
If a partner consistently finds the strings bothersome, a healthcare provider can assess the length and may trim them slightly shorter. However, trimming the strings too short can sometimes make them stiffer or more difficult to grasp when the IUD needs to be removed.
Self-Monitoring: How to Check the IUD
A routine self-check is the recommended way to monitor the IUD’s placement and involves feeling for the strings, not the device itself. To perform this check, wash your hands thoroughly and get into a comfortable position, such as squatting or sitting. Gently insert a finger into the vagina until you can feel the cervix, which has a firm, rubbery texture similar to the tip of a nose.
The strings should be felt protruding slightly from the opening of the cervix. It is recommended to check the strings monthly, often after the end of a menstrual period, to ensure they feel the same length as the previous check. Feeling the strings confirms the IUD is likely still in the correct location and providing effective contraception. If the strings feel significantly longer, shorter, or are completely absent, seek medical advice.
When Feeling Means Trouble
Certain sensations or changes can signal that the IUD has shifted out of its proper position and requires immediate attention from a healthcare provider. The most significant warning sign is feeling the hard, plastic part of the IUD itself poking out of the cervix or into the vagina. This sensation indicates a partial expulsion, meaning the device has migrated downward and is no longer reliably preventing pregnancy.
Other symptoms include the strings feeling much longer or shorter than they did during the last self-check, or being unable to locate them at all. Additionally, experiencing severe, persistent cramping that is much worse than normal menstrual pain, or pain during sexual intercourse, can suggest the IUD is displaced or embedded. Any of these abnormal sensations, along with unexplained heavy bleeding or a fever, should prompt the use of a backup birth control method and an immediate appointment for an IUD check.