An intrauterine device (IUD) offers highly effective, long-lasting birth control, preventing pregnancy for several years. While many experience seamless use, concerns about the body “rejecting” the device sometimes arise. True immunological rejection, like with an organ transplant, does not occur with an IUD. Instead, what individuals perceive as rejection are typically complications related to the IUD’s physical position, such as displacement or expulsion. This article clarifies these issues and guides on recognizing potential problems.
What “Rejection” Means for an IUD
Issues with an IUD relate to its physical position within the uterus. The most common complications include expulsion, where the IUD partially or completely falls out, and displacement, where it shifts from its correct location.
Less common but more serious issues can arise, such as embedment, where the IUD becomes partially lodged in the uterine wall, or perforation, which involves the IUD puncturing the uterine wall. These movements can occur due to strong uterine contractions, improper insertion technique, or a mismatch between IUD size and the uterine cavity. Expulsion is most common in the first few months after insertion, particularly in individuals who have recently given birth.
Signs and Symptoms of an IUD Problem
Recognizing specific signs and symptoms helps identify a potential IUD complication. Severe or worsening abdominal pain or cramping, beyond typical menstrual discomfort, can indicate an issue. Unusual or heavy bleeding, or bleeding between menstrual periods, may signal a problem with the IUD’s position.
Changes in IUD strings are a common indicator: if they cannot be felt, or feel significantly shorter or longer, the IUD may have moved. Some individuals might even feel the hard plastic of the IUD itself, indicating partial expulsion. Signs of infection, such as fever, chills, or unusual vaginal discharge, warrant immediate medical attention. Pain during sexual intercourse could suggest the IUD is out of place or irritating surrounding tissues. An unexpected pregnancy with an IUD in place should prompt immediate medical evaluation, as it may signal a dislodged or ineffective device.
Normal IUD Side Effects Versus Complications
It is important to differentiate between expected side effects and more serious complications. Many individuals experience initial cramping and light spotting for a few days to weeks after IUD insertion. These symptoms are usually mild and resolve.
Changes in menstrual bleeding patterns are common, particularly in the first few months. Hormonal IUDs may lead to lighter periods or even cessation of periods, while copper IUDs can initially cause heavier bleeding and more intense cramping. These changes usually improve as the body adjusts. In contrast, persistent, severe, or worsening symptoms—such as continuous heavy bleeding, extreme pain not relieved by over-the-counter medication, or signs of infection—indicate a complication.
When to Seek Medical Attention
If you suspect your IUD has moved or experience concerning symptoms, contact a healthcare provider promptly, such as your doctor, gynecologist, or a local clinic. Do not attempt to adjust or remove the IUD yourself, as this can cause further complications.
If an IUD issue is suspected, especially if symptoms indicate a loss of contraceptive efficacy, use a backup birth control method, such as condoms, to prevent unintended pregnancy. If the IUD has completely expelled, save the device and bring it to your medical appointment for examination. Healthcare providers can diagnose IUD complications through physical examination, ultrasound, or X-ray, and discuss management options.