An intrauterine device (IUD) is a small, T-shaped birth control method placed inside the uterus to prevent pregnancy. These devices are highly effective, offering over 99% protection. For an IUD to remain effective, it must stay in its correct position within the uterine cavity.
Understanding IUD Displacement
IUD displacement occurs when the device moves from its intended position inside the uterus, ranging from a slight shift to partial or complete expulsion. When displaced, an IUD’s ability to prevent pregnancy is reduced, increasing the risk of unintended pregnancy. Displacement can also lead to discomfort or other complications.
Recognizing Potential Indicators
While some people might not experience symptoms with a slightly displaced IUD, a significant shift can cause noticeable changes. A common indicator is a change in menstrual patterns, such as heavier, longer, or more irregular periods, particularly if you have a hormonal IUD that previously lightened your flow. For those with a copper IUD, changes might include lighter-than-usual menstruation or a return to pre-insertion menstrual cycles.
Increased or new pelvic pain and cramping may be sharp, sudden, or persistent and not relieved by over-the-counter medication. Other symptoms include unusual vaginal discharge, pain during sexual intercourse, or your partner being able to feel the IUD during sex. In cases of partial expulsion, you might even feel the hard plastic part of the IUD protruding from your cervix.
Checking Your IUD Strings
Regularly checking your IUD strings is a way to monitor its position. Your healthcare provider will typically show you how to do this 4-6 weeks after insertion and recommend monthly self-checks, often after your period. Begin by washing your hands thoroughly with soap and water, ensuring cleanliness under your nails to minimize infection risk.
Next, find a comfortable position (e.g., sitting, squatting, or placing one leg on an elevated surface). Gently insert your index or middle finger into your vagina until you can feel your cervix, which has a firm, rubbery texture similar to the tip of your nose. The IUD strings, which are thin and about 2 inches long, should be felt poking through the cervix. They feel like short pieces of fishing line.
If you can feel the strings and their length is consistent with previous checks, your IUD is likely in place. However, if the strings feel longer or shorter than usual, or if you cannot feel them at all, it could indicate that the IUD has moved. Do not pull on the strings, as this could further displace the IUD. Even if you cannot feel the strings, it does not always mean the IUD is displaced; sometimes, they coil up against the cervix.
When to Seek Professional Advice
Contact a healthcare provider if you suspect your IUD has moved or if you experience any concerning symptoms. Specific situations that warrant a doctor’s visit include being unable to feel your IUD strings, feeling the hard plastic part of the IUD, or experiencing new or worsening pain, severe cramping, or unexplained changes in bleeding patterns. Seek immediate medical attention if you experience:
Heavy bleeding that soaks through menstrual products quickly
Blood clots the size of a quarter or larger
Chills
A fever above 101°F (38°C)
If you have had recent unprotected sex and suspect displacement, use a backup birth control method, or discuss emergency contraception options with your provider. A healthcare professional will typically perform a pelvic exam to check the IUD strings and may use tools like a cytobrush to locate them. If the strings are not visible, an abdominal or transvaginal ultrasound can confirm the IUD’s position within the uterus. In rare cases, an X-ray might be used to locate the device if it is suspected to have moved outside the uterus. Never attempt to reposition or remove the IUD yourself.