An intrauterine device (IUD) is a highly effective, long-acting reversible contraceptive placed inside the uterus. These small, T-shaped devices have thin strings attached to their base, which extend through the cervix and into the upper part of the vagina. These strings serve a practical purpose: they allow for self-checking to confirm the IUD’s presence and enable a healthcare provider to easily remove the device when needed. If you notice your IUD strings seem longer or are hanging out, it is a common concern that warrants attention from a medical professional.
Normal IUD String Position
When an IUD is correctly in place, its strings rest high in the vagina, near the cervix. These strings are about 1 to 2 inches long and feel like thin, soft pieces of fishing line. They are designed to be felt with a finger during a self-check, but they are not visible from outside the body.
To check for your IUD strings, first wash your hands thoroughly. Then, in a comfortable position such as squatting or sitting, insert an index or middle finger into your vagina until you feel your cervix, which has a firm, rubbery texture similar to the tip of your nose. You should then be able to feel the IUD strings coming through the cervix. This monthly self-check helps you become familiar with the normal position of your strings, allowing you to detect any changes.
Why Strings Might Seem Longer
If your IUD strings feel longer than usual or are hanging out of the vagina, several reasons could explain this change. One primary concern is partial IUD expulsion, where the device has begun to move out of the uterus and into the cervix or vagina. This can occur if the uterus contracts around the IUD, pushing it downwards. Partial expulsion can compromise the IUD’s effectiveness in preventing pregnancy.
Another possibility is IUD displacement, where the device has shifted within the uterus but has not fully exited. This can happen in the first few months after insertion, often due to strong uterine cramps or the unique shape of the uterus. Sometimes the strings were initially cut to a longer length by the provider, or they may have simply softened and uncurled over time, making them feel longer.
Immediate Steps to Take
If you observe your IUD strings are longer or hanging out, it is important to take immediate, specific steps. First, do not attempt to pull on the strings or try to push the IUD back into place. Manipulating the device yourself could cause further displacement or injury.
Second, use a backup method of contraception, such as condoms, until you can be evaluated by a healthcare provider. Avoid vaginal intercourse during this time to prevent potential complications or unintended pregnancy. Promptly contact your healthcare provider to schedule an appointment for an evaluation.
Medical Evaluation and Outcomes
Upon contacting your healthcare provider, they will likely schedule an appointment to assess the situation. The evaluation begins with a physical examination, where the provider will visually inspect and palpate for the IUD strings and cervix. If the strings are not easily located or their position is unclear, a pelvic ultrasound may be performed to confirm the IUD’s exact location within the uterus. This imaging technique uses sound waves to create detailed images, allowing the provider to determine if the IUD is correctly positioned.
Several outcomes are possible following the medical evaluation. In some cases, the IUD may be confirmed to be in its correct position, and the longer strings might simply be a variation in length or due to the strings settling. If the IUD is found to be partially expelled or displaced, the provider may recommend its removal. Repositioning a partially expelled IUD is not recommended, as it indicates the uterus is attempting to expel it.
After removal, your provider will discuss options for replacement IUDs or alternative birth control methods. Addressing any concerns about IUD string changes with a healthcare professional is important.