The Intrauterine Device, or IUD, is a small, T-shaped instrument inserted into the uterus, offering one of the most effective forms of long-acting reversible contraception (LARC). IUDs are over 99% effective at preventing pregnancy and can last for several years, depending on the specific type—some hormonal versions last for three to eight years, while copper IUDs can function for up to ten years. Because the device is placed internally, regular medical follow-up is important to ensure it remains correctly positioned, functions properly, and is well-tolerated by the user. A schedule of check-ups and self-awareness of symptoms are necessary for continuous efficacy and safety.
The Critical First Follow-Up
The very first check-up after insertion is a specific, one-time safety confirmation, distinct from ongoing maintenance visits. This appointment is typically scheduled between four and six weeks after the IUD is placed, or shortly after the user’s first menstrual period post-insertion. The main purpose of this initial visit is to verify that the IUD has settled correctly within the uterine cavity.
The first few weeks after placement are when the risk of partial or complete expulsion is highest. During this check, a healthcare provider will visually confirm the IUD strings are still visible and of the correct length, indicating the device is likely in place. This visit is also an opportunity to discuss any immediate post-insertion side effects, such as persistent cramping or unusual spotting.
Standard Routine Check-Up Schedule
After the initial post-insertion visit, the required frequency of check-ups decreases significantly. Current medical guidelines suggest that no specific routine follow-up visit is strictly required if the user has no concerns. However, many healthcare providers still recommend an annual check-up to ensure continuous efficacy.
This yearly review often coincides with the patient’s regular well-woman visit or gynecological exam. These scheduled visits allow the provider to address any ongoing side effects or changes in menstrual bleeding patterns. The annual appointment ensures the device continues to meet the user’s reproductive health needs.
Signs That Require Immediate Consultation
Certain symptoms require an unscheduled, immediate consultation with a healthcare provider. Severe, persistent, or worsening pelvic pain or abdominal cramping that is not relieved by over-the-counter pain medication is a serious warning sign. This type of pain could indicate a rare but serious complication, such as a pelvic inflammatory infection (PID) or movement of the device.
Signs of infection, including an unexplained fever, chills, or unusual, foul-smelling vaginal discharge, also necessitate prompt medical attention. A patient should immediately contact a doctor if they experience a significant change in bleeding, such as soaking more than one pad per hour for several consecutive hours. Missing a menstrual period can be an early sign of pregnancy; if pregnancy occurs with an IUD in place, there is an increased risk of an ectopic pregnancy, which is a medical emergency.
The inability to feel the IUD strings during a self-check, or if the strings feel significantly shorter, longer, or if the plastic tip of the device itself can be felt, suggests the IUD may have shifted or been expelled. In such cases, the device’s contraceptive protection may be compromised, and a backup method should be used until a clinician can confirm the position with an exam or ultrasound. The healthcare provider must be consulted without delay for any of these specific symptoms.
What Happens During an IUD Check-Up
During a scheduled check-up, the healthcare provider will typically begin by taking a detailed history of the patient’s experience with the device. This discussion covers satisfaction with the IUD, any side effects like changes in periods or cramping, and confirmation of whether the patient has been checking for the IUD strings. This is a chance to assess any changes in health status that might affect the IUD’s appropriateness.
The physical part of the examination involves a pelvic exam, where the provider uses a speculum to visualize the cervix and confirm the IUD strings are still present and appear to be the correct length. In cases where the strings cannot be seen, a provider may use a specialized tool or an ultrasound to confirm the IUD’s location within the uterus. This examination ensures the device is still positioned to provide maximum contraceptive protection.