Intrauterine devices (IUDs) are small, T-shaped contraceptive devices placed inside the uterus. They are highly effective, offering over 99% efficacy and providing long-term birth control for several years, depending on the type. For continued effectiveness, the IUD must remain in its correct position.
Routine Self-Checks
Regularly checking for your IUD strings is a standard way to confirm its placement. These are thin threads that extend from the IUD through the cervix into the vagina. You should perform this check monthly, often after your menstrual period, as the cervix may be lower and the strings easier to locate.
To check, wash your hands thoroughly. Then, while sitting or squatting, insert your index or middle finger into your vagina until you feel your cervix, which has a firm, rubbery texture. Gently feel for the fine strings protruding from the cervix. If you can feel the strings and they seem to be the same length as previous checks, your IUD is likely in place.
Signs of Potential Expulsion
Several signs might indicate that your IUD has moved or expelled from its proper position. One indicator is a change in the length or presence of the IUD strings; they might feel shorter, longer, or completely absent when you check for them. Feeling the hard, plastic part of the IUD itself at your cervix or in your vagina is another clear sign of potential expulsion.
You might also experience unusual or severe pain and cramping in your abdomen or pelvis, which can differ from typical menstrual discomfort. Changes in your bleeding patterns, such as heavier or prolonged bleeding, or spotting between periods, could also suggest a problem. Some individuals might also notice an abnormal vaginal discharge.
In some instances, a sexual partner might feel the IUD during intercourse. Although rare, it is possible for an IUD to expel without noticeable symptoms, especially during a heavy menstrual flow. If you suspect your IUD has moved, or if you begin to experience symptoms of pregnancy, it is important to seek medical advice.
Immediate Steps After Suspected Expulsion
If you suspect your IUD has fallen out or moved, contact a healthcare provider promptly. Until its position is confirmed, use a backup method of birth control, such as condoms, to prevent unintended pregnancy. Avoid attempting to push the IUD back into place or remove it yourself, as this could cause further displacement or injury. Your healthcare provider can determine the IUD’s location through a physical exam and potentially an ultrasound. Depending on the findings, they can discuss options such as reinsertion or alternative contraception.
Understanding IUD Expulsion
IUD expulsion, where the device partially or completely comes out of the uterus, is not common, but it can occur. This is most likely within the first few months after insertion or during a menstrual period. Expulsion can be partial, meaning the IUD moves but remains partly within the uterus, or complete, where it exits the body entirely.
Certain factors increase the likelihood of expulsion. Individuals with heavy periods or severe cramping have a higher risk, as strong uterine contractions might dislodge the device. Other factors include IUD insertion immediately after childbirth or a second-trimester abortion, being younger than 20-24 years old, or having a uterus with an irregular shape due to conditions like fibroids.