An intrauterine device (IUD) is a small, T-shaped form of long-acting reversible contraception inserted into the uterus by a healthcare professional. This device provides highly effective pregnancy prevention over several years. To ensure the IUD remains safe and fully functional, regular medical monitoring is necessary. Check-ups allow a doctor to confirm proper placement and address any potential concerns.
The Standard IUD Follow-Up Schedule
The period immediately following insertion is the most critical time for monitoring, as the risk of the IUD shifting or being expelled is highest within the first few months. Many clinicians advise scheduling an initial follow-up appointment approximately four to six weeks after the IUD is placed. This early check-in serves to verify that the device has settled correctly into the uterine cavity.
While some current guidelines suggest a routine post-insertion check is not strictly mandatory, many patients find this initial visit valuable for reassurance and symptom review. After this initial phase, the need for check-ups transitions to a less frequent schedule.
The IUD is then typically checked during the patient’s annual well-woman examination. This yearly assessment often coincides with other routine screenings like a Pap test. This routine timing allows a healthcare provider to confirm the device’s continued efficacy and address any subtle long-term side effects. The yearly check continues for the entire duration the IUD is in place, which can range from three to ten years depending on the specific type of device.
What to Expect During a Doctor’s Check
During a scheduled IUD check, the examination is generally brief and focused on confirming the device’s position. The primary action a doctor takes is to visually inspect the IUD’s strings, which are thin threads attached to the device that extend through the cervix into the vagina.
The clinician will use a speculum, similar to a routine pelvic exam, to visualize the cervix and confirm that the strings are visible and appear to be the correct length. String length is an important indicator of placement; if the strings are significantly longer or shorter than previously noted, it could suggest the IUD has moved.
If the strings are not visible, the doctor may gently probe the cervical canal or use transvaginal ultrasound to confirm the IUD remains correctly positioned within the uterus. This quick imaging can definitively rule out migration or expulsion.
The doctor will also discuss the patient’s experience since the last visit, focusing on any changes in menstrual bleeding, cramping, or overall satisfaction with the birth control method. They will inquire about any unexpected side effects, such as persistent spotting or pain, and review patient self-monitoring efforts.
Urgent Reasons to See Your Doctor Immediately
Beyond the standard schedule, certain signs and symptoms indicate a problem that requires an immediate, unscheduled visit to a healthcare provider. One of the most common issues is suspected IUD expulsion or displacement, which is often signaled by a change in the strings. This includes being unable to feel the strings when performing a self-check, or the strings feeling noticeably longer or shorter than normal.
Another serious concern is the development of an infection, most notably Pelvic Inflammatory Disease (PID), which carries the highest risk in the first few weeks after insertion. Symptoms that necessitate urgent medical attention include severe and persistent lower abdominal or pelvic pain, especially if it is worse than typical cramping. This pain may be accompanied by fever, chills, or an unusual vaginal discharge that is foul-smelling or discolored.
Severe, sudden, or worsening pain that is not relieved by over-the-counter medication is a warning sign that should not be ignored. Furthermore, while rare, pregnancy with an IUD in place carries an increased risk of ectopic pregnancy, where the fertilized egg implants outside the uterus. Any symptoms of pregnancy combined with severe, unilateral (one-sided) abdominal pain require immediate evaluation.