Intrauterine Devices (IUDs) are a highly effective, long-term, and reversible form of birth control. An IUD is a small, T-shaped device inserted into the uterus to prevent pregnancy. While IUDs are generally reliable, they can shift from their original position, though this is not frequent.
Understanding IUD Stability
An IUD is designed to remain securely within the uterine cavity. During insertion, a healthcare provider places the small, T-shaped device through the cervix and into the uterus. Its flexible arms extend within the uterus, and its T-shape helps wedge it into place.
The uterus’s natural shape and muscular walls also help hold the IUD in position. IUDs are a highly effective method of contraception, with a pregnancy rate of less than 1% per year.
How IUDs Can Shift
Despite their design for stability, IUDs can sometimes shift from their optimal position within the uterus. One way this can happen is through partial expulsion, where the IUD slips downward into the cervix. This can progress to a complete expulsion, meaning the IUD falls entirely out of the body. This is more common within the first few months after insertion.
A rarer, but more serious, form of movement is uterine perforation, where the IUD punctures through the uterine wall. This can be a complete perforation, where the IUD enters the abdominal cavity, or a partial perforation, where part of the IUD remains in the uterine wall. Migration, where the IUD moves to other parts of the body outside the uterus, is also a rare possibility.
Factors that may contribute to IUD shifts include the insertion technique, strong uterine contractions (particularly during menstruation), or certain uterine anatomies, such as a small uterine cavity or structural irregularities like fibroids.
Identifying a Displaced IUD
Recognizing signs of a displaced IUD is important for continued contraceptive effectiveness and addressing health concerns. A primary indicator is a change in the IUD strings. Users may notice the strings feel shorter or longer than usual, or they might be unable to feel them at all. However, some individuals may not be able to feel their IUD strings from the beginning, or the strings may simply curl up inside the cervix.
Other symptoms suggesting IUD movement include increased or persistent pain and cramping in the abdomen or pelvis. Abnormal bleeding patterns, such as heavier or irregular menstruation, or spotting between periods, can also be a sign. Some individuals might physically feel the IUD itself, or their partner may feel the device during sexual activity. In some instances, unusual vaginal discharge or fever could indicate an infection related to displacement.
Actions for Suspected IUD Movement
If there is any suspicion that an IUD has moved, contact a healthcare provider immediately. Do not attempt to reposition or remove the IUD independently, as this could lead to further complications or injury. Until proper placement is confirmed by a healthcare professional, use a backup method of contraception, such as condoms, to prevent unintended pregnancy, as a displaced IUD may not be effective.
A healthcare provider will perform a pelvic examination to check the IUD strings and assess the device’s position. If strings are not visible or displacement is suspected, an ultrasound may confirm the IUD’s location within the uterus. In rare cases where the IUD cannot be located via ultrasound, an X-ray of the abdomen and pelvis might be performed. Depending on the findings, the healthcare provider will discuss appropriate next steps, which may include removal of the displaced IUD and potentially inserting a new one.