Intrauterine devices (IUDs) are considered a safe, convenient and effective method of birth control. But occasionally these small devices can slip out of place.
Inserted inside the uterus, IUDs eliminate the need for a daily pill and prevent pregnancy with 99 percent effectiveness for three to 12 years, depending on the type of device used.
While side effects are possible with any contraception, complications with IUDs occur in less than 1 percent of women. But it’s important to recognize the signs and symptoms if your IUD moves.
Where Can an IUD Go?
IUDs are generally placed through the vagina, past the cervix and into the uterus, where the strings hang about two inches down from the uterus into the vagina.
It is rare for the IUD to move from where your doctor initially places it, but it does happen. An IUD may:
Perforate through the uterine wall into the gynecologic, urinary or gastrointestinal system organs.
Migrate into the pelvic or abdominal cavity
When this happens, patients might experience discomfort, which could require a doctor’s visit to retrieve the IUD.
General discomfort is expected following the insertion of an IUD. Cramping, backaches and even spotting are normal and usually resolve within three to six months. If you experience any of the following, however, your IUD may be out of place:
Intense pain that isn’t eased by NSAIDs like ibuprofen
Heavy or abnormal bleeding
Pain and bleeding that continue after six months
Your partner feeling the IUD during sexual intercourse.
The most common symptoms associated with a displaced IUD are pain and bleeding. If you suspect your IUD has moved out of position, don’t try to take the device out on your own. Your healthcare provider will be able to determine movement with an exam and testing.
Some women do not experience any symptoms when their IUD shifts, which is why many doctors advise a monthly self-check to ensure the strings are still present.
Causes of IUD Movement
There are several factors that can contribute to the movement or absorption of an IUD. The shape, size and positioning of the uterus, as well as uterine abnormalities, can all affect the body’s response to an IUD. Women with uterine fibroids, or noncancerous growths on the uterus, may also have a higher risk of IUD expulsion.
Ultrasounds are not typically conducted, but your OB-GYN will factor in medical history such as the known presence of fibroids or rare anomalies before recommending an IUD. If an IUD is not advised, your practitioner will suggest alternative methods of birth control.
Treatment will depend on the positioning of the IUD, whether it’s migrated into the cervix or been absorbed by the uterus. An ultrasound can determine positioning and treatment.
There are several ways an IUD can be removed:
If the string is visible, your provider can pull it to remove the device.
Hysteroscopy, a procedure in which fluid is inserted into the uterus to make the string accessible.
Laparoscopy, which is only performed in rare cases where perforation of the uterine wall is suspected. This is a simple surgical procedure to locate and remove the IUD from a more difficult to reach location.
If your IUD requires removal, your doctor may be able to replace the device during the same visit, depending on whether you have fibroids or infection and whether expulsion is likely to reoccur.
Additionally, if a woman recently had a baby and the uterus has not yet returned to its normal size, a physician may delay the reinsertion of an IUD if the first one is unsuccessful.
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