An intrauterine device (IUD), often called a coil, is a small, T-shaped form of long-acting reversible contraception that a healthcare provider places inside the uterus. These devices are highly effective, offering protection for three to ten years. Removal is a routine medical procedure performed safely in a clinic, and it is typically faster and involves less discomfort than insertion.
Common Reasons for Removal and Optimal Timing
The most frequent reason for removal is the expiration of the device’s lifespan, which ranges from three to ten years depending on the type. Removal is necessary to maintain contraceptive effectiveness or when the patient desires to become pregnant.
Patients may also choose removal due to unwanted side effects, including persistent heavy bleeding, chronic cramping, or hormonal symptoms like mood changes. Less commonly, removal is necessary if the device has shifted position, become embedded in the uterine wall, or if a pelvic infection develops.
Timing the removal is important if the goal is to avoid immediate pregnancy, as conception is possible right away if the person is ovulating. Providers often suggest scheduling removal during the first week of the menstrual cycle if no new contraceptive is being inserted immediately after. If a new method is being started immediately, the timing within the cycle is less critical for preventing pregnancy.
The Professional Removal Procedure
The coil removal procedure is performed by a trained healthcare professional. The patient is positioned on the examination table similar to a routine pelvic exam. The provider inserts a speculum into the vagina to hold the walls open, allowing clear visualization of the cervix.
The IUD has retrieval strings that extend out of the cervix into the vaginal canal. The provider uses a specialized grasping tool, such as forceps, to locate and gently secure these strings. The device is then removed by applying steady, gentle traction.
As the T-shaped device is pulled, its flexible arms fold upward, allowing it to slide easily through the cervical opening. This typically causes a brief, sharp sensation or a momentary cramp, which is generally less painful than the initial insertion. Taking an over-the-counter pain reliever about an hour before the appointment can help minimize discomfort.
Patients should never attempt to remove the IUD themselves. Attempting self-removal can cause pain, incomplete contraception, or complications like infection or uterine injury. If the strings are not visible, the provider uses specific medical techniques, such as a specialized hook or ultrasound guidance, to safely locate and extract the device without causing harm.
Immediate Effects and Planning After Removal
Immediately following the removal, it is common to experience some minor physical side effects. Mild cramping, similar to menstrual cramps, may occur for a few hours, and some people may have light bleeding or spotting for a few days. These short-term effects can often be managed with rest and over-the-counter pain relief.
One of the most significant immediate effects of coil removal is the rapid return of fertility. The ability to conceive is restored almost immediately, regardless of whether the device was hormonal or copper. Studies show that the majority of women who try to conceive after IUD removal become pregnant within one year.
For those who had a hormonal IUD, the body may go through a temporary adjustment period as natural hormone production resumes. This shift can sometimes lead to temporary mood changes, breast tenderness, or a change in the menstrual cycle pattern for a few weeks. The first period after removal may be different in timing or flow, but cycles usually normalize within a couple of months.
If the intention is to avoid pregnancy after the coil is removed, it is crucial to have a new contraceptive plan prepared and implemented immediately. Because fertility returns so quickly, any delay can put the person at risk of conception. This new method should be ready to start either immediately before or on the day of the removal appointment.