An Intrauterine Device (IUD) is a small, T-shaped contraceptive device placed directly inside the uterus, offering long-term and highly effective birth control. A menstrual disc, in contrast, is a flexible, ring-shaped barrier designed to be folded and inserted into the vaginal fornix, where it collects menstrual fluid. It stays in place by tucking securely behind the pubic bone. The central question for many IUD users is whether these two products can be safely used together without compromising the IUD’s position or effectiveness.
Understanding the Safety Concerns and Risk Factors
Using a menstrual disc with an IUD is generally considered acceptable, but it carries a slight, theoretical risk of accidental expulsion. The primary concern is the potential for the IUD to be pulled out of position or expelled entirely during the removal of the menstrual product. This risk is often conflated with that of menstrual cups, which rely on a vacuum seal for placement, creating a downward suction force that could potentially dislodge the IUD by pulling on its strings.
Menstrual discs are mechanically different from cups because they are held in place by anatomy, resting against the pubic bone, and do not require suction. Because of this design difference, discs are often considered a safer option for those with an IUD. However, while the risk from a vacuum seal is largely eliminated, a mechanical risk remains. This involves the disc’s rim or the user’s fingers inadvertently catching the IUD strings and exerting a direct pull during the removal process.
Scientific data specifically on menstrual disc use and IUD expulsion rates is currently limited. However, studies investigating menstrual cups have shown an increased association with IUD expulsion compared to other menstrual products. For example, one clinical trial involving copper IUD users found that those who used a menstrual cup had a significantly higher rate of expulsion than non-users. These findings highlight the sensitivity of the IUD strings to downward force or snagging. To mitigate the mechanical risk with a disc, users must exercise extreme care to ensure the IUD strings remain safely out of the path of the disc and their fingers during removal.
Essential Techniques for Safe Disc Removal
Successfully managing the mechanical risk of expulsion depends on mastering a gentle and strategic removal technique. The first step involves positioning the body to naturally lower the cervix and the disc. This is achieved by sitting or squatting over a toilet and engaging the pelvic floor muscles, which helps nudge the disc forward from behind the pubic bone.
Once the disc has shifted slightly, the user inserts a clean finger to locate the front rim. The action is not a quick or forceful yank, but rather a methodical, slow unhooking. The finger should gently catch the rim and pull it slightly downward and forward, ensuring the disc is released from its tucked position.
The most critical element is performing a “sweep” with the finger around the perimeter of the disc before pulling it out. This action confirms that the IUD strings are not trapped between the disc’s rim and the vaginal wall, which prevents a direct tug on the IUD upon removal. Pulling the disc out while keeping it horizontal helps maintain the device’s placement and minimizes the chance of catching the strings.
Many modern discs incorporate a small notch, loop, or stem to aid in this careful removal. Regardless of the disc’s design, the removal must always be slow and gentle, allowing the user to immediately stop if any resistance or unusual sensation is felt. If the strings feel too long, consulting a healthcare provider about shortening them can further reduce the risk of accidental snagging.
Identifying Signs of IUD Migration or Expulsion
Understanding the signs of IUD movement is important for any user, particularly those using internal menstrual products. A dislodged IUD can lead to a loss of contraceptive efficacy and may cause discomfort, necessitating prompt medical attention. The most common indicator is a change in the length of the IUD strings, which a user should check regularly after the menstrual period.
If the strings feel significantly longer or shorter than usual, or if they cannot be felt at all when they were previously accessible, it may signal that the IUD has shifted. Sudden, severe, or persistent cramping, distinct from typical menstrual cramps, is another warning sign. A partially expelled IUD may cause heavy or irregular bleeding, or a noticeable increase in vaginal discharge.
In some cases, a user may feel the hard plastic tip of the IUD itself protruding from the cervix, which is a clear sign of partial expulsion. Pain during sexual intercourse can also indicate that the device is out of place. Any combination of these symptoms should prompt an immediate call to a healthcare provider, and a backup method of contraception should be used until the IUD’s position is confirmed.