Intrauterine devices (IUDs) are T-shaped devices inserted into the uterus to prevent pregnancy. These small devices offer a highly effective and long-lasting form of contraception. They are a popular choice for many individuals seeking reversible birth control. IUDs work by stopping sperm from reaching and fertilizing eggs, and some types also release hormones to further prevent pregnancy.
Defining IUD Expulsion
IUD expulsion refers to the device moving out of its correct position within the uterus. This movement can range from a slight shift to the IUD completely exiting the body. Complete expulsion occurs when the IUD fully comes out of the uterus, often unnoticed by the individual.
Partial expulsion means the IUD has shifted from its optimal placement but remains partly inside the uterus or cervix. In either scenario, the IUD may no longer be effective at preventing pregnancy. Understanding the distinction between these two types of expulsion is important for recognizing potential issues.
Expulsion Rates and Contributing Factors
IUD expulsion is uncommon, with rates typically ranging from 2% to 10% of users. The uterus is a muscular organ that contracts, and these contractions can sometimes push the IUD out of place. Several factors can influence the likelihood of an IUD expelling.
Younger age, particularly among individuals aged 14–19 years, is associated with a higher risk of expulsion. Individuals who experience heavy menstrual bleeding or severe cramping may also have an increased chance of expulsion. This can be due to stronger uterine contractions attempting to expel the device.
The timing of IUD insertion relative to childbirth also plays a role. IUDs placed immediately or early postpartum have higher expulsion rates compared to those inserted several weeks or months later. Specifically, postpartum insertions after a vaginal delivery carry a greater risk of expulsion than those following a cesarean delivery. Uterine characteristics, such as unusual size, shape, or the presence of fibroids, can also contribute to displacement if there is insufficient space for the IUD.
Identifying Expulsion and Taking Action
Recognizing the signs of IUD expulsion is important for maintaining contraceptive protection. One of the most common indicators is a change in the length of the IUD strings. The strings may feel noticeably shorter or longer than usual, or they might become completely undetectable. Individuals might also feel the hard, plastic part of the IUD itself, which should not be palpable when correctly in place.
Other signs include new or worsening pain, such as severe or persistent cramping, and changes in menstrual patterns, such as heavier or irregular bleeding or unexpected spotting. Some individuals may experience unusual vaginal discharge. If a sexual partner feels the IUD during intercourse, this also indicates displacement. If any of these signs appear, contacting a healthcare provider promptly is necessary. Until the IUD’s position is confirmed, using an alternative form of contraception, such as condoms, is important to prevent unintended pregnancy.