Intrauterine devices (IUDs) are a highly effective form of long-term reversible contraception. An IUD is a small, T-shaped device inserted into the uterus to prevent pregnancy. Widely used, IUDs have success rates over 99% in preventing pregnancy, making them a preferred choice for many.
Understanding IUD Placement
A healthcare provider inserts the IUD into the uterus, where it remains in a specific position for optimal effectiveness. This placement allows the device to function as intended, by releasing hormones or copper ions to prevent fertilization and implantation. The IUD typically sits at the top of the uterus, with two thin strings extending through the cervix into the vagina. These strings allow users and healthcare providers to regularly check that the IUD remains in its correct position, confirming it has not shifted.
Signs of IUD Displacement
IUD displacement often presents with pain. This can include sharp, sudden pain or persistent pelvic cramping that differs from typical menstrual discomfort. This pain may stem from the IUD pressing against uterine walls or the cervix as its position shifts. Pain during sexual intercourse can also suggest the IUD has moved lower in the uterus or is partially expelled.
Beyond pain, changes in the IUD strings are a common sign of displacement. The strings might feel longer or shorter than usual, or become undetectable. This occurs because the IUD has shifted within the uterus, altering the visible length of the strings.
Unexpected bleeding or spotting between periods, heavier menstrual bleeding, or increased vaginal discharge can also signal displacement. A person might even feel the hard plastic of the IUD at the vaginal opening or within the vagina, indicating significant movement or expulsion. These symptoms arise because an improperly positioned IUD can irritate the uterine lining, leading to discomfort and altered bleeding patterns.
What to Do If You Suspect Movement
If you suspect your IUD has moved, contact your healthcare provider promptly. Avoid attempting to adjust or remove the IUD yourself, as this could cause injury or further displacement. Your provider will recommend an immediate appointment to assess the situation and determine the IUD’s position.
During the visit, the healthcare provider may perform a pelvic exam to check the IUD strings and feel for the device. An ultrasound is often used to confirm the IUD’s exact location within the uterus. Depending on the degree of displacement, the IUD may need to be removed. While slight repositioning is sometimes possible if the IUD is still effective, complete removal and replacement with a new device are often necessary to ensure continued contraceptive protection.
Causes of IUD Displacement
Several factors can contribute to an IUD moving from its position within the uterus. Uterine contractions, especially strong ones during menstruation, can push the IUD downwards, leading to partial or complete expulsion. This is more common in the first few months after insertion. Improper initial insertion, where the device is not placed high enough, can also predispose it to shifting.
Rarely, vigorous physical activity or strenuous exercise may be associated with IUD displacement. The uterus may naturally contract more frequently or intensely, increasing the likelihood of the IUD moving. The risk of expulsion is highest in the first year after insertion, especially for those who have not previously given birth.