An intrauterine device (IUD) is a small, T-shaped contraceptive device placed inside the uterus by a healthcare provider. IUDs are an effective contraception method, preventing pregnancy for several years depending on the type. While generally safe and effective, an IUD can sometimes shift from its correct position within the uterus.
Signs of IUD Displacement
Recognizing signs of IUD displacement is important. One of the most common indicators is a change in the IUD strings. These thin threads normally hang a few inches into the vaginal canal for self-checks. If the strings feel noticeably shorter, longer, or become entirely undetectable, it may suggest the IUD has moved.
Experiencing new or increased pain can also signal a displaced IUD. This might include sharp, sudden cramping, persistent abdominal discomfort, or pain during sexual intercourse. While some cramping is normal after insertion, pain that is severe, worsening, or unrelieved by over-the-counter pain relievers warrants attention. Unusual or heavier bleeding patterns, or changes in menstrual flow that deviate from what is typical with your IUD, can also be a sign. For instance, a hormonal IUD usually reduces bleeding, so a return to heavy periods could indicate displacement.
A person might also physically feel the IUD itself, such as a hard, plastic part of the device at the cervix or within the vagina, which should not be possible if correctly positioned. A sexual partner might also report feeling the IUD during intercourse. Unusual vaginal discharge could also be a symptom of IUD irritation or displacement.
Common Reasons for IUD Shifting
Several factors can contribute to an IUD shifting from its intended position. Strong uterine contractions, particularly during menstruation, are a common cause for IUD displacement. This is especially true within the first three months after insertion, as the uterus adjusts. The size and shape of the uterus can also play a role; structural irregularities like fibroids or congenital uterine abnormalities may limit space, potentially leading to expulsion.
Incorrect insertion technique, while rare with trained professionals, can contribute to an IUD not being properly seated, making it more prone to movement. Vigorous physical activity or straining is less common as a direct cause but can be associated with displacement. IUDs inserted immediately or soon after childbirth, or in individuals under 20, may have a slightly higher likelihood of shifting due to ongoing uterine changes or smaller uterine cavities.
Immediate Actions to Take
If you suspect your IUD has moved, immediate action is important for your health and continued contraceptive protection. Do not attempt to adjust, push, or pull the IUD yourself; trying to manipulate the device can further dislodge it or cause injury. Instead, contact your healthcare provider or gynecologist as soon as possible to schedule an examination.
Until a healthcare professional confirms the IUD’s position, use a backup birth control method, such as condoms. A displaced IUD may no longer be effective at preventing pregnancy, increasing the risk of unintended conception. Also, avoid vaginal intercourse or inserting anything into the vagina, such as tampons, until your IUD’s position has been confirmed. This reduces the risk of further displacement or potential complications.
Your healthcare provider will likely perform a pelvic exam and may use an ultrasound to accurately determine the IUD’s location within the uterus. In some cases, if the IUD strings are not visible, they might use a small brush or an X-ray to locate the device.
Potential Outcomes of Displacement
A displaced IUD carries several potential consequences, from reduced contraceptive effectiveness to more serious health complications. The primary concern is the increased risk of unintended pregnancy. If the device is not correctly positioned, it may no longer effectively prevent sperm from reaching an egg or hinder implantation, compromising its contraceptive function.
While rare, a displaced IUD can increase the risk of pelvic inflammatory disease (PID), particularly if partially expelled or if bacteria are introduced during insertion or subsequent movement. PID is an infection of the reproductive organs that can lead to chronic pelvic pain or infertility if left untreated. Although the risk of PID with modern IUDs is generally low and primarily confined to the first few weeks after insertion, new signs of infection should be evaluated.
Another rare but serious complication is uterine perforation, where the IUD punctures the uterine wall. This can occur during insertion or, less commonly, later if the IUD shifts. Symptoms may include severe abdominal pain or changes in bleeding patterns, and if the IUD moves into the abdominal cavity, it might require surgical removal. If an IUD is confirmed to be displaced, it will likely need to be removed, and a new IUD may be inserted, often during the same visit.