Intrauterine Devices, or IUDs, are small, T-shaped contraceptive devices inserted into the uterus. There are two primary types: hormonal IUDs, which release progestin, and copper IUDs, which are hormone-free. These devices prevent pregnancy for a specific duration, typically ranging from 3 to 12 years, depending on the brand and type. For example, Kyleena is approved for 5 years, Mirena for up to 8 years, and the Paragard copper IUD for up to 12 years. Knowing what happens if an IUD remains in place beyond its recommended lifespan is important for reproductive health.
Diminished Contraceptive Protection
Leaving an IUD in past its recommended lifespan compromises its primary function of pregnancy prevention. Hormonal IUDs work by continuously releasing progestin, which thickens cervical mucus, thins the uterine lining, and can sometimes inhibit ovulation. Over time, the reservoir of hormones within the device depletes, leading to a gradual decrease in hormone release and, consequently, reduced contraceptive efficacy. This means the protective mechanisms weaken, increasing the chance of an unintended pregnancy.
Copper IUDs prevent pregnancy by creating an inflammatory reaction within the uterus that is toxic to sperm and eggs, inhibiting fertilization. With prolonged use, the copper wire on these devices can undergo degradation and corrosion, potentially lessening its spermicidal and ovicidal effects. Relying on an expired IUD for birth control carries a clear risk of an unintended pregnancy.
Increased Risk of Complications
Beyond reduced contraceptive effectiveness, leaving an IUD in for an extended period can lead to several health complications. One common concern is increased difficulty with removal. An IUD may embed itself in the uterine wall or cervix over time, or the device itself could become brittle and break during an attempted removal. Such scenarios can make removal more complex, possibly requiring specialized tools or procedures like hysteroscopy.
While the highest risk of Pelvic Inflammatory Disease (PID) is typically soon after insertion, a prolonged IUD presence may contribute to a low, ongoing risk of infection. The device itself does not cause PID, but can facilitate bacterial ascent if an infection is present. More serious, though rare, complications include uterine perforation or migration. Although perforation typically occurs during insertion, the device might embed more deeply or, in rare instances, perforate the uterine wall over a prolonged period.
If the IUD migrates, it can move from its original position, sometimes even into the abdominal cavity, necessitating surgical removal. An IUD left in place for many years beyond its intended use might cause chronic inflammation or irritation of the uterine lining. Individuals may also experience changes in bleeding patterns, such as heavier or irregular periods, particularly with expired hormonal IUDs, as the hormone release diminishes. Pelvic pain can also develop if the IUD is displaced or has become embedded.
Guidance on Next Steps
If an IUD has remained in place longer than its recommended lifespan, consulting a healthcare provider immediately is the appropriate next step. They can assess the situation and recommend the safest course of action. The removal process is typically a quick procedure performed in a clinic setting. However, if the IUD has embedded or its strings are not visible, the removal might be more involved, potentially requiring specialized instruments or a minor procedure to safely retrieve the device.
After removal, individuals have several options to consider. A new IUD can often be inserted during the same visit, if desired. A healthcare provider can also discuss other forms of contraception that align with current lifestyle and family planning goals. Attempting to remove an IUD without medical supervision is not advised. Self-removal can lead to injury, incomplete removal of the device, or an increased risk of infection.