An intrauterine device (IUD) is a highly effective form of contraception, widely used for its long-term benefits. While IUDs are generally considered safe and reliable, understanding potential concerns, such as the device shifting from its intended position, can help users feel more informed and secure.
Types of IUD Movement
An IUD can move in several distinct ways from its optimal placement within the uterus. One type is displacement, where the IUD remains entirely inside the uterus but is no longer in its correct fundal position. It might be located in the lower uterine segment or cervix, or it could be rotated or inverted. A displaced IUD can still be within the uterine cavity, but its effectiveness may be compromised.
Another type of movement is partial expulsion, which occurs when part of the IUD moves through the cervix and into the vagina. A portion of the device might be felt or seen extending from the cervical opening. In contrast, complete expulsion is when the IUD entirely exits the uterus and body. This can happen without the user noticing, especially if it occurs during menstruation.
The most serious, though rare, type of movement is perforation, where the IUD punctures or moves through the uterine wall. This can be a complete perforation (outside the uterus) or a partial perforation (embedded in the uterine wall). Perforation can lead to complications such as bleeding or damage to surrounding organs.
Key Factors Influencing IUD Movement
Several factors can influence whether an IUD shifts from its intended position within the uterus. Uterine anatomical characteristics, such as shape and size, can affect proper IUD retention. For example, irregularities like fibroids, an unusual shape, or an IUD that is too large for the uterine cavity can make it challenging for the device to remain correctly positioned.
Strong uterine contractions, particularly those experienced during menstruation or immediately after childbirth, can also contribute to IUD movement. IUDs inserted shortly after childbirth, especially after a vaginal delivery, have a higher rate of expulsion compared to those inserted at other times. This is partly because the uterus needs time to return to its pre-pregnancy size.
The technique used during IUD insertion is also a significant factor. Improper placement, such as not positioning it high enough in the fundus, can increase the likelihood of displacement or expulsion. A skilled healthcare provider who correctly measures the uterine depth and ensures fundal placement helps reduce these risks. Everyday activities like exercise or sexual intercourse typically do not cause a properly placed IUD to shift.
Recognizing a Displaced IUD
Recognizing the signs of a displaced IUD is important for prompt action. A common indicator is a change in the IUD strings, typically checked monthly. Strings that feel shorter or longer than usual, or the inability to feel them at all, can suggest the IUD has moved. If the hard plastic part of the IUD can be felt, this is a clear sign of displacement.
Physical symptoms may also arise if an IUD has shifted. New or worsening cramping, persistent pelvic pain, or pain during sexual intercourse can signal a problem. Changes in bleeding patterns, such as irregular bleeding, unexpected spotting, or heavier periods than usual, might also indicate displacement. For those with a hormonal IUD, a return to heavier bleeding after previously experiencing lighter periods could be a sign.
Since a displaced IUD can compromise contraceptive effectiveness, any symptoms suggestive of pregnancy should be considered a potential sign of IUD failure. These symptoms include nausea, breast tenderness, or a missed period. Regular self-checks of the IUD strings can help with early detection, but any unusual or concerning symptoms warrant medical evaluation.
Steps to Take After IUD Displacement
If you suspect your IUD has shifted, contacting a healthcare provider promptly is important. A medical professional can accurately assess the IUD’s position through examination or imaging, such as an ultrasound. Attempting to adjust or remove the IUD yourself is not recommended, as this can cause further harm or complications.
Using a backup method of contraception, like condoms, is advised immediately if IUD displacement is suspected. This is because the device’s effectiveness in preventing pregnancy may be compromised. While awaiting medical assessment, avoid tampons or sexual intercourse if experiencing pain or unusual bleeding, to prevent exacerbating discomfort or potential infection.
During your appointment, the healthcare provider will discuss the findings and potential next steps, which may include removing the IUD. Depending on the situation and your preferences, a new IUD might be inserted during the same visit, or other contraceptive options can be explored. Open communication with your provider ensures your concerns are addressed and you receive appropriate care.