It’s uncommon, but if you have an IUD, it could move out of place.
“This can mean several things,” says Peace Nwegbo-Banks, MD, an obstetrician and gynecologist at Serenity Women’s Health and Med Spa in Houston:
- Your IUD may have come out of your uterus.
- Your IUD may not be positioned correctly, or it could be embedded in the walls of your uterus.
- Your IUD may have cut your uterus and traveled through it into your abdomen or peritoneal cavity.
Your doctor will schedule a checkup about a month after you get your IUD to make sure it’s still in the right place. When an IUD moves, it usually happens within the first few months after you get it.
If your IUD isn’t in the right place, you could get pregnant, so it’s important to know what to look for.
First, Get to Know Your IUD Strings
Your IUD comes with strings. They’re thin and light, like fishing line or a lightweight plastic thread. They hang about 2 inches down from your uterus into your vagina. Your doctor will cut them to the right length for your body.
The best way to know if your IUD is out of place is to check the strings regularly. Do it once a month, at the end of your period, or if you feel strange cramping during your period.
First wash your hands. Then sit or squat, and put one finger into your vagina. Feel for your cervix, which is hard and rubbery, like the tip of your nose. The strings should come through your cervix. Feel for the strings, but don’t pull them.
If they feel the same every month, your IUD is likely in place.
Signs Your IUD Is Out of Place
Call your doctor and use a backup form of birth control if you notice any of these signs:
- You can’t feel the strings. If you check but can’t find them, they could be up inside your uterus.
- Your strings are shorter or longer than usual. If they’re a different length, the IUD could have shifted. Checking your strings regularly makes it easier to notice changes.
- You feel the IUD itself. When your IUD is in the right place, you should only feel the strings. You shouldn’t feel the hard, plastic part of the IUD poking out.
- Your partner feels the IUD. When the IUD is in place, you and your partner shouldn’t feel it. You may feel the strings but not the plastic part. If you have sex and your partner feels the hard, plastic part, it may have moved.
- You feel pain. If the pain is extreme, gets worse, or doesn’t go away 3-6 months after you get the IUD, it may be out of place. If you have this kind of pain and NSAIDs like ibuprofen or naproxen don’t help, call your doctor.
- You have heavy or abnormal bleeding. Spotting and bleeding are common after you get an IUD, but heavy or abnormal bleeding could mean it’s in the wrong spot. “Heavy vaginal bleeding may accompany a uterine perforation,” Nwegbo-Banks says.
- You have severe cramping, abnormal discharge, or fever. These are other signs that your IUD has moved. They may also be signs of an infection. Talk to your doctor to find out what’s causing these symptoms.
It’s possible for an IUD to come out of place without any signs. “Some women may be asymptomatic and not feel anything even if the IUD is out of place,” Nwegbo-Banks says. Check your strings on a regular basis can help you figure out if it’s in a different place.
Can You Get Hurt if It’s Out of Place?
It’s rare, but you may have complications if your IUD moves.
If the IUD cuts your uterus near important blood vessels, you may have bleeding and problems with blood flow to your organs, Nwegbo-Banks says. If it cuts your uterus and moves through it into your abdominal cavity, it can cause localized inflammatory reactions, bowel adhesions, or bowel perforations.
What to Do if You Think Your IUD Is Out of Place
First, call your doctor. Start using your backup birth control method. If you’re in pain, it may be best to wait to have sex until after you see the doctor. You might need emergency contraception if you had sex recently.
What Will Your Doctor Do?
They’ll check to see if your IUD is where it should be. If it isn’t, they’ll remove it or replace it.
If your IUD moved but the doctor isn’t sure exactly where it is, they’ll give you a full exam and workup that includes an ultrasound and other tests to find it.
The doctor will talk to you about replacing the IUD or changing to a different form of birth control.