Key Takeaways
- It’s important to be aware of potential signs of IUD displacement, such as changes in the length of the IUD strings, new or worsening pain and cramping, unusual bleeding or discharge, or feeling the plastic tip of the IUD.
- Several factors can increase the risk of IUD displacement, including the first few months after insertion, strong uterine cramps, and structural irregularities in the uterus.
- If you suspect your IUD has moved, it’s important to avoid trying to adjust it yourself and instead consult with a healthcare professional, using a barrier method of contraception in the meantime if you have penis-in-vagina sex.
When the doctor inserts your IUD, they leave one or two thin plastic strings hanging down into your vaginal canal. These strings are about 2 inches long, so you may be able to feel them with the tip of your longest finger.
Some experts recommend checking for these strings after your menstrual period (if you have a copper IUD) or period-like withdrawal bleeding (if you have a hormonal IUD) ends. IUDs are more likely to shift during periods of vaginal bleeding.
If the strings feel longer or shorter than usual, or you suddenly can’t feel the strings after being able to touch them in previous months, there’s a chance your IUD may have moved.
However, this is only a reliable indicator if you have a history of being able to feel your IUD strings. Many people can’t feel the strings from the start, likely because the strings coil inside the cervix.
In either case, it’s important to take note of any unusual symptoms or changes in how you feel. A dislodged or expelled IUD can cause many new or worsening symptoms.
You may not experience any new or unusual symptoms if your IUD only shifts slightly out of place. However, a significant change in placement can affect how the device releases hormones or copper into your body.
If you have a hormonal IUD, you might develop unexpected or excessive period-like bleeding. This bleeding can be particularly concerning if you’re accustomed to a lighter flow or have stopped experiencing withdrawal bleeding.
If you have a copper IUD, you might notice lighter-than-usual menstruation or a return to your pre-insertion menstrual cycle. This change may look like a shorter or longer time between menstrual periods.
In either case, you might experience:
- sharp, sudden cramps
- irregular vaginal bleeding
- unusual vaginal discharge
- pain during vaginal penetration
If the IUD has partially expelled from your uterus, you or a sexual partner may be able to feel the plastic tip of the T-shaped device in your vaginal canal.
IUDs are more likely to move out of place within the first 3 months of insertion. However, the likelihood decreases after 12 months. Strong uterine cramps typically cause IUD displacement.
The shape and size of your uterus, rather than the tilt, usually affects the IUD’s position.
Structural irregularities can result in a smaller-than-average uterine cavity. These irregularities might include uterus arcuatus or bicornus, which can be present from birth, or fibroids, which develop later in life.
If there isn’t enough room in your uterus to accommodate the IUD, your body may begin to expel the device.
Similarly, you may be more likely to experience displacement if a doctor inserts your IUD during or soon after periods of uterine growth and development.
Teenagers, for example, experience significant changes in uterine size during puberty. A 2020 research review suggested that uterine growth continues into later adolescence.
Pregnancies that extend into the second or third trimester cause your uterus to grow far beyond its typical size. It can take up to 6 weeks after an abortion, pregnancy loss, or birth for your uterus to return to its prepregnancy state.
If you think your IUD has moved and you can feel the strings or plastic, do not try to adjust or shift it back into place. Tugging on the strings or plastic may further dislodge the device.
Similarly, if your IUD has completely expelled from your uterus and fallen out of your vaginal canal, do not attempt to reinsert it back into your body.
Unless your symptoms are severe, you may be able to wait until an appointment with the healthcare professional who inserted your IUD is available.
Just be sure to use a condom or another barrier method if you decide to have penis-in-vagina sex before then. Your IUD may not be effective at preventing pregnancy if it’s moved from its original position.
Get immediate medical attention if you develop:
- bleeding that quickly soaks through menstrual products
- blood clots the size of a quarter or larger
- chills
- fever above 101°F (38°C)
- pain that interferes with your ability to perform daily activities
Your healthcare professional can start by performing a pelvic exam. They may be able to see the strings after inserting a speculum into your vaginal canal and inspecting your cervical opening with a magnifying instrument.
If not, they can use a cytobrush to swab the inside of your cervical opening and retrieve the IUD strings. They may perform an abdominal or transvaginal ultrasound to confirm the position of the device inside your uterus.
If your healthcare professional can’t locate your IUD via ultrasound, they can take an X-ray of your abdomen and pelvis. They may conclude that the device has completely expelled from your body if it doesn’t appear on X-rays.
Many people are unable to find their IUD strings. The length of your vaginal canal, the timing of your menstrual cycle, and how short the doctor cuts your IUD strings can affect whether you’re able to feel the strings.
It’s usually not a cause for concern unless you develop unusual symptoms.
Your healthcare professional must remove an IUD that has partially expelled from your uterus or moved to other parts of your body. They can usually insert a new IUD during the same appointment.
If the IUD has completely expelled from your body, talk with your healthcare professional about your options for contraception. You may decide to start a different form of birth control or have them insert a new IUD.