An Intrauterine Device (IUD) is a small, T-shaped form of birth control placed inside the uterus by a healthcare provider. These devices offer a highly effective and long-lasting method of contraception, preventing pregnancy for several years. While IUDs are generally very reliable, the device can shift from its intended position. Understanding the factors involved in IUD movement can help users feel more informed.
How Often Does It Happen?
IUD displacement or expulsion, where the device moves out of its correct position or completely falls out, is not a common occurrence. The risk is highest during the first three months after insertion, gradually decreasing after the initial year. Studies indicate that approximately 2-10% of IUD users may experience some form of expulsion within the first year. This can include partial expulsion, where the IUD has shifted but remains partly within the uterus, or complete expulsion, where it exits the body entirely.
Why IUDs Move
Several factors can contribute to an IUD moving. Strong uterine cramps, particularly during menstruation, are a common cause as the uterus naturally contracts to expel its contents. The initial insertion process also plays a role; if the IUD is not correctly fitted or placed initially, it may be more prone to shifting.
The unique shape and size of an individual’s uterus can also influence IUD stability. Variations in uterine anatomy, such as a very small uterine cavity, the presence of fibroids, or a congenital malformation like a bicornuate uterus, can make it challenging for the IUD to remain securely in place. If the uterus does not have sufficient space to accommodate the device, the body may attempt to expel it.
Certain individual characteristics can increase the likelihood of displacement. Heavy menstrual bleeding is recognized as a significant risk factor for IUD expulsion. Individuals in younger age groups, especially those under 24, or those who have had four or more children, may have a slightly higher risk. While vigorous activities might be a factor, normal daily physical activities, including exercise and sexual intercourse, do not cause an IUD to move.
Signs of Displacement
Recognizing the signs that an IUD may have moved is important. One common indicator is a change in the IUD strings. These thin threads, which typically hang through the cervix into the top of the vagina, are used to confirm the IUD’s position. If the strings feel noticeably shorter or longer than usual, or if they cannot be felt at all, it may suggest the IUD has shifted.
Another sign is being able to feel the hard plastic part of the IUD at the cervix or within the vagina. New or worsening abdominal pain and cramping can also indicate displacement. Changes in bleeding patterns, such as unexpected or excessive bleeding with a hormonal IUD, or unusually light menstruation with a copper IUD, may also occur.
Other signs include unusual vaginal discharge, or pain during sexual intercourse. An IUD can shift without causing any noticeable symptoms, which is why regular self-checks of the strings can be helpful. If an IUD is displaced, its effectiveness in preventing pregnancy may be compromised.
What to Do If Your IUD Moves
If you suspect your IUD has moved, contacting a healthcare provider immediately is the most important step. Until you have been evaluated, it is advisable to use a backup method of birth control or abstain from sexual activity, as the IUD’s contraceptive protection may be compromised.
Avoid attempting to reinsert or remove the IUD yourself. Pulling on the strings or trying to adjust the device can cause further displacement or injury. During your appointment, the healthcare provider will perform a pelvic exam to check the IUD strings and may use an ultrasound or X-ray to confirm its position.
If the IUD is confirmed to be displaced, it will generally need to be removed. A new IUD can be inserted during the same visit, provided there are no other complications or contraindications.