An intrauterine device (IUD) offers effective, long-term birth control when placed directly into the uterus. While generally reliable, an IUD can occasionally be expelled, meaning it partially or completely falls out. Understanding what this might look and feel like, along with knowing what steps to take, can help individuals manage this situation.
Visual Characteristics of an Expelled IUD
When an IUD falls out, it appears as the entire device. IUDs are small, T-shaped instruments. The main body, or stem of the ‘T’, is usually between 30 and 36 millimeters long, and the arms are around 28 to 32 millimeters wide.
The device is made from flexible plastic. Hormonal IUDs, such as Mirena or Kyleena, release progestin. Copper IUDs, like Paragard, have a thin copper wire coiled around the stem. Two thin strings extend from the bottom of the IUD. These strings, typically 1 to 2 inches long, are trimmed by a healthcare provider after insertion for placement checks and eventual removal. An expelled IUD will be the intact device, including its T-shape and strings.
Recognizing the Signs of Expulsion
An IUD may not always be visually apparent if expelled, especially during a menstrual period. However, several physical signs and sensations can indicate an IUD has moved or fallen out. A common indicator is a change in the IUD strings. Individuals are often advised to regularly check for these strings by gently inserting a finger into the vagina. If the strings feel shorter or longer than usual, or cannot be felt, it suggests possible displacement or expulsion.
Other signs include changes in menstrual bleeding patterns, such as heavier or more painful periods than normal. Increased cramping, even severe, can also be a symptom, as the uterus may be contracting to push out the device. Some individuals may experience unusual vaginal discharge or discomfort during sexual intercourse. In some cases, a person or their partner might feel the hard plastic tip of the IUD itself protruding from the cervix or in the vaginal canal.
Immediate Steps After Expulsion
If an IUD is suspected or confirmed to be expelled, immediate action is important. The first step is to contact a healthcare provider promptly. They can confirm expulsion and discuss next steps, which may include a physical examination or an ultrasound to determine the device’s position.
Until a healthcare provider is consulted, it is important to use a backup method of birth control, such as condoms, to prevent unintended pregnancy. If unprotected intercourse has occurred, considering emergency contraception might be necessary, and a pregnancy test should be taken if there is any concern about pregnancy. It is important to avoid attempting to reinsert the IUD personally, as this could cause injury.