Using a menstrual disc with an Intrauterine Device (IUD) is generally safe for most individuals. Understanding the distinct placement and function of both devices, along with proper usage techniques, can help minimize concerns and ensure safe combined use.
Understanding Menstrual Discs and IUDs
A menstrual disc is a flexible, circular device designed to collect menstrual fluid. It is inserted into the vaginal fornix, the wider cavity in the upper vaginal canal, just beneath the cervix. The disc is held in place by tucking its front rim behind the pubic bone, allowing it to cover the entire cervix and collect flow without obstructing the vaginal canal. This design allows for up to 12 hours of wear time and can even accommodate mess-free sexual activity during menstruation.
An IUD is a small, T-shaped contraceptive device placed inside the uterus by a healthcare provider. There are two main types: copper IUDs and hormonal IUDs. The IUD works by affecting sperm movement and survival, preventing them from reaching an egg, and altering the uterine lining to prevent a fertilized egg from implanting. Once inserted, short strings (typically 1 to 2 inches long) extend from the IUD through the cervix into the top of the vagina. These strings are used by a medical professional for checking placement and removal.
Safety Considerations for Combined Use
The primary concern with menstrual disc use and an IUD is the potential for the disc to dislodge or expel the IUD, mainly due to suction or inadvertent pulling on the strings. Menstrual cups, which create a vacuum seal, have been more commonly associated with this theoretical risk due to suction during removal. Menstrual discs, however, are generally considered to create less suction compared to menstrual cups because they are held in place by the pubic bone, not a vacuum seal.
While rare, IUD expulsion with menstrual disc use is possible. Proposed mechanisms for IUD expulsion with menstrual products include accidentally pulling on the strings during removal or suction displacing the IUD. Some research, particularly concerning menstrual cups, suggests a possible association with increased IUD expulsion rates. However, conflicting evidence exists, and more studies are needed to fully understand this risk. Factors such as individual pelvic anatomy, the length and position of IUD strings, and the specific removal technique can influence the likelihood of displacement.
Tips for Safe Use
To reduce potential risk when using a menstrual disc with an IUD, proper insertion and removal techniques are important. Before insertion, wash your hands and the disc with mild, fragrance-free soap and water. Pinch the disc in half, making it similar in size to a tampon, and angle it downwards and backwards towards your tailbone as you insert it into the vaginal canal. Push the disc as far back as it comfortably goes, ensuring it covers your cervix, and then tuck the front rim up behind your pubic bone to secure it.
For removal (up to 12 hours after insertion), wash your hands and relax your pelvic floor muscles by taking deep breaths. To minimize suction, break the disc’s seal before pulling it out. Slide a finger into your vagina until you feel the front rim of the disc, then hook your finger under the rim and gently pull it out slowly, keeping it parallel to the floor to avoid spills. If you have difficulty reaching the disc, bearing down with your pelvic muscles, similar to having a bowel movement, can help bring the rim within reach. Regularly checking your IUD strings after each period can help you notice changes in their length, which could indicate an IUD shift.
When to Consult a Healthcare Professional
Consult a healthcare professional if you experience signs or symptoms suggesting your IUD may have shifted or been expelled. These signs include:
- Unusual or severe cramping, especially if it persists or worsens.
- Abnormal vaginal bleeding that is heavier than usual or occurs unexpectedly.
- A change in the length of your IUD strings, such as them feeling shorter or longer than usual, or if you can no longer feel them.
- Feeling the hard, plastic part of the IUD poking out of your cervix, or if your partner feels the IUD during intercourse.
- Unusual vaginal discharge, fever, or pain during vaginal penetration.
If you suspect your IUD has been displaced, use a backup birth control method immediately to prevent unintended pregnancy.