Suspecting your intrauterine device (IUD) is moving out of place can be unsettling. An IUD is a small, T-shaped device inserted into the uterus, providing highly effective, long-term contraception. While IUDs are reliable, expulsion, where the device partially or completely exits the uterus, can rarely occur. Knowing what to do if you suspect this is important for your health and continued contraception.
Recognizing Signs of Expulsion
A common indicator of IUD expulsion is a change in the length or feel of its strings. You might notice the strings feel longer or shorter than usual, or they might be completely missing when you check for them. Some individuals may also feel the IUD’s hard plastic part at the cervix opening or within the vagina.
Unusual or severe pain and cramping, particularly if different from typical menstrual discomfort or pain after insertion, can indicate an issue. Abnormal bleeding patterns, such as heavier than usual periods, prolonged bleeding, or spotting between cycles, may also be present. In some instances, the IUD may visibly fall out of the vagina.
If the IUD has expelled, its contraceptive effectiveness is compromised. This can lead to pregnancy symptoms or a positive pregnancy test, as the device no longer provides protection. Promptly recognizing these signs and seeking medical attention is important.
Immediate Steps to Take
If you suspect IUD expulsion, contact a healthcare provider (gynecologist or urgent care clinic) immediately. They can confirm the IUD’s position and provide guidance. If sexually active, use a backup contraception method, such as condoms, immediately.
Avoid attempting to pull on or reinsert a partially expelled IUD, as this could cause injury. Refrain from sexual intercourse until evaluated by a healthcare professional to prevent complications. If the IUD has completely fallen out, keep the device and bring it to your appointment to show your doctor.
Understanding Why Expulsion Occurs
IUD expulsion, though uncommon, can occur for several reasons. Strong uterine contractions, like those during menstruation or immediately after insertion, can sometimes push the device out. Individuals who experience heavy or prolonged menstrual bleeding may also have a slightly increased risk of expulsion.
Factors related to individual uterine anatomy or history can also influence the likelihood of expulsion. For example, individuals who are younger or have never given birth may have a slightly higher rate of expulsion compared to those who have had children. A history of previous IUD expulsion also increases the chance of recurrence. Additionally, certain uterine abnormalities (e.g., fibroids) or incorrect initial insertion can contribute to expulsion.
Medical Evaluation and Follow-Up
After suspecting IUD expulsion, a healthcare professional will typically perform a pelvic exam to check its position. An ultrasound may also confirm if the device is still in the uterus and its exact location. This evaluation helps determine if the IUD has partially or completely expelled.
Following confirmation of expulsion, your doctor will discuss your options. If appropriate and desired, reinsertion of a new IUD might be considered. Alternatively, you may choose to explore other birth control methods that better suit your needs. Your provider will also address any complications, such as ongoing pain or heavy bleeding, resulting from the expulsion. Follow-up appointments are important for proper healing and continued contraceptive care.