An intrauterine device (IUD) is a highly effective, long-acting, reversible form of contraception placed inside the uterus. A menstrual disc is a flexible, rimmed device inserted into the vaginal fornix to collect menstrual fluid. For individuals with an IUD, discs are generally compatible, provided careful attention is paid to the technique used during insertion and removal.
Understanding the Difference Between Cups and Discs
The concern about using an internal menstrual product with an IUD is the potential for it to physically dislodge the device. The IUD has thin strings that extend through the cervix into the vaginal canal. If an internal product creates suction or if the strings are accidentally pulled, the IUD could shift position or be expelled entirely.
Menstrual cups are typically bell-shaped and rely on a mild suction seal against the vaginal walls to stay in place. Studies suggest menstrual cup use may be associated with a higher rate of IUD expulsion compared to non-users, likely due to accidental pulling on the strings or vacuum pressure. IUD users are often advised to break the cup’s seal before removal.
A menstrual disc is held in place by the physical anatomy of the body, not by suction. The disc is tucked high up in the vaginal fornix, secured behind the pubic bone. Because the disc does not create a vacuum seal, it is a lower-risk option for IUD users than a menstrual cup. The primary risk with disc use is accidentally snagging the IUD strings during the removal process.
Minimizing Risk During Removal
The removal process is the most delicate part of using a menstrual disc with an IUD, as the strings are vulnerable to being snagged or pulled. Before insertion, discuss IUD string length with a healthcare provider, as shorter strings are less likely to be caught. When inserting the disc, it is important to ensure the strings are tucked up inside the collecting basin or are not trapped beneath the disc’s rim.
Safe removal requires a slow, deliberate technique that prevents tugging on the strings. Before reaching for the disc, bear down slightly with the pelvic floor muscles; this gently pushes the disc lower and makes it easier to reach the rim. Once a clean finger is hooked under the rim, the first step is to untuck the disc from behind the pubic bone.
The disc should be pulled out gently and horizontally, following the natural curve of the vaginal canal, rather than pulling straight down. Pulling the disc parallel to the floor helps keep the IUD strings out of the way and prevents downward force that could pull on the cervix. If the strings are felt during the removal process, immediately stop, reposition the finger to avoid them, and continue the removal with extreme caution.
Monitoring Your IUD and When to Seek Medical Advice
Adopting a new internal menstrual product requires increased vigilance, especially in the first few cycles after starting disc use. It is recommended to wait at least one or two full menstrual cycles after IUD insertion before introducing any internal products, allowing the device to settle fully in the uterus. Before each new menstrual cycle begins, perform a self-check of the IUD strings.
To check the IUD, insert a clean finger into the vagina until the cervix is reached, which feels firm and round like the tip of a nose. The two thin IUD strings should be felt extending slightly out of the cervical opening. Note the length and feel of these strings, as they can sometimes feel longer or shorter depending on the stage of the menstrual cycle.
If the IUD strings feel significantly shorter, longer, or cannot be felt at all, the IUD may have shifted position or been expelled. Pain during intercourse, unexpected heavy bleeding, or severe cramping are also signs that the IUD may have moved. If the hard plastic or silicone of the IUD itself can be felt, this indicates it is no longer properly positioned. Any of these warning signs should prompt an immediate consultation with a healthcare provider for an examination to confirm the IUD’s placement.