An Intrauterine Device (IUD) is a highly effective, long-acting form of reversible contraception placed directly into the uterus. This small, T-shaped device features one or two thin strings that extend through the cervical opening into the upper part of the vagina. These strings serve two purposes: confirming the device remains securely in position and allowing a healthcare provider to remove the IUD. Feeling these threads is normal and confirms the IUD is likely where it should be, ensuring its contraceptive protection is active.
Why IUD Strings Exist and Their Normal Feel
The presence of IUD strings allows for professional management and self-monitoring. They are typically made of soft, flexible plastic or nylon, feeling similar to a fine fishing line or dental floss. After insertion, the provider cuts them to hang approximately one to two inches outside the cervix, resting high in the vaginal canal.
The strings are meant to be felt with a finger to confirm the device has not shifted from the top of the uterus. Over time, the material often softens and may curl slightly around the cervix, making them less noticeable. The expected sensation is the touch of these thin threads, not the hard body of the T-shaped device itself. Consistent feel from month to month is a reassuring sign of correct placement.
Step-by-Step Guide to Self-Checking
Regularly checking the strings helps monitor the IUD’s position. This check should be performed once a month, ideally after menstruation has ended, since the cervix sits lower then, making the strings easier to reach. Establishing a routine helps accurately track any changes in string length or feel.
To begin, thoroughly wash your hands with soap and water to minimize the risk of introducing bacteria. Find a comfortable position, such as squatting or standing with one leg elevated on a surface. Gently insert the longest finger into the vagina until it reaches the cervix, which feels firm and round, similar to the tip of your nose.
Once the cervix is located, feel for the two thin threads emerging from its center opening. Only feel the strings and note their length relative to your last check; never pull on them. Consistent length and the presence of both threads confirm the IUD’s position. If the strings feel dramatically shorter, longer, or cannot be found, contact a healthcare provider.
Common String Concerns
One of the most frequent concerns is the inability to feel the strings. This can occur if they have simply coiled up into the cervical canal, a common occurrence that happens without the IUD moving from its correct position. The IUD remains fully effective, but a healthcare provider may need to use a small brush or instrument to sweep the strings back into view for confirmation.
A more serious concern arises if the strings feel noticeably longer than before, indicating the IUD has partially moved down or is expelling. Partial expulsion means the device is no longer fully seated within the uterus, and its contraceptive effectiveness may be significantly reduced. If you feel the hard plastic tip of the IUD itself protruding from the cervix, this is a clear sign of expulsion and requires immediate medical attention.
In rare cases, the strings may be absent because the IUD has perforated the uterine wall and migrated into the abdominal cavity, an event that typically happens during insertion. If the strings cannot be located, use a backup method of contraception and schedule an appointment with a provider immediately. They will likely use an ultrasound to confirm the IUD’s exact location.
Other Warning Signs of IUD Complications
Other symptoms besides string changes can indicate a complication requiring prompt medical evaluation. The sudden onset of severe cramping or persistent pelvic pain that does not resolve with over-the-counter pain relievers may signal that the IUD has shifted or is causing an adverse reaction.
Changes in bleeding patterns that deviate from what is expected are also a concern. This includes heavy, prolonged, or significantly abnormal bleeding, especially if a hormonal IUD previously caused lighter periods. Signs of infection, such as fever, chills, or unusual vaginal discharge with a foul odor, suggest a possible pelvic infection that needs quick treatment.