Intrauterine devices, commonly known as IUDs, are small, T-shaped birth control devices inserted into the uterus. They are a highly effective form of long-acting reversible contraception (LARC), providing pregnancy prevention for several years, depending on the type. While IUDs are generally very reliable, it is possible for them to move from their intended position within the uterus.
How IUDs Can Shift Position
An IUD can shift position in several ways, each with distinct implications for its effectiveness and the individual’s health. One form of movement is partial expulsion, where the IUD begins to exit the uterus, moving into the cervix or even the upper part of the vagina.
Total expulsion occurs when the IUD entirely leaves the uterus and the body. This can happen unnoticed, leading to a loss of contraceptive protection. The IUD might also shift its placement within the uterine cavity, known as displacement or migration. The device could sit lower than intended, rotate, or move to an incorrect angle, compromising its efficacy.
Perforation is a serious, though very rare, type of IUD movement where the device penetrates the uterine wall. This can be partial, meaning the IUD is partly embedded in the wall, or complete, passing entirely through the wall and potentially entering the abdominal cavity. Perforation is a rare complication, often occurring during the insertion procedure.
Factors Contributing to IUD Movement
Several factors can contribute to an IUD shifting from its correct position. Uterine contractions are a common natural occurrence, particularly during menstruation or in the postpartum period, and can exert pressure that may lead to IUD displacement or expulsion.
Improper insertion technique by a healthcare provider can increase the risk of an IUD moving. If the device is not placed high enough within the uterine fundus or correctly anchored, it may be more prone to shifting. Uterine anatomical variations, such as fibroids or atypical uterine shapes, can affect how well an IUD stays in place.
IUDs inserted immediately after childbirth carry an elevated risk of expulsion. The uterus is still recovering and returning to its pre-pregnancy size and shape, making it less stable for IUD retention. A history of a previous IUD expulsion significantly increases the likelihood of another. Extreme physical exertion or trauma, though uncommon, could theoretically contribute to IUD movement in rare circumstances.
Recognizing IUD Displacement
Recognizing signs of IUD displacement is important for individuals to seek timely medical attention. A common indicator is a change in the IUD strings; they might feel shorter, longer, or completely missing when checked. Individuals might also feel the plastic part of the IUD in the vagina or cervix, which indicates it has moved significantly out of place.
New or worsening pelvic pain, cramping, or discomfort during sexual intercourse can signal the IUD is no longer in its correct position. Changes in menstrual bleeding patterns, such as heavier, longer, or more frequent periods, or unexpected spotting, may occur. An unexpected pregnancy is also a sign of IUD failure due to displacement. If any of these signs are present, it is important to contact a healthcare provider for evaluation.
What to Do After Suspected IUD Movement
If IUD movement is suspected, contact a healthcare provider immediately for professional evaluation. Attempting to adjust or remove the IUD independently can cause harm and should be avoided. Until a healthcare provider confirms the IUD’s position and effectiveness, use a backup contraception method, such as condoms, or abstain from sexual intercourse to prevent unintended pregnancy.
During the medical appointment, the healthcare provider will perform a physical examination to check the IUD strings and may use an ultrasound to confirm the device’s location within the uterus. This evaluation helps determine if the IUD is properly positioned or if it needs to be removed or replaced. Following the provider’s guidance ensures safety and continued contraceptive protection.