An intrauterine device (IUD) is an effective form of birth control that is inserted directly into the uterus. The most common types of IUDs are copper or hormonal IUDs. The copper variant slowly releases copper ions, which are toxic to sperm, whereas the hormonal variant thickens the cervical mucus, which makes it difficult for sperm to penetrate the uterus. This results in an impressive failure rate of only 1%.
However, no technology is perfect. Considering that the risk of IUD expulsion at 5 years is 5%, it’s important to keep a close eye on your IUD to ensure it hasn’t moved or shifted incorrectly. Learn the common causes for an IUD shifting, along with what to watch for and how to handle the situation if it happens to you.
What Causes an IUD to Move?
First and foremost, it’s important to distinguish the fact that there is normal movement with an IUD and dangerous displacement. An IUD may shift slightly over time but typically remains very close to its original placement, as any significant movement can cause pain, ineffectiveness, or even internal injury. The most common causes of significant shifts in an IUD include:
- Incorrect placement during insertion
- Uterine contractions, especially during periods
- Physical activity or sexual intercourse
- Uterine abnormalities, such as fibroids
- Postpartum changes in the uterus
Remember, though, that major shifts in an IUD are rare. The most common time for an IUD to shift is within the first 3 months after insertion, so this is when you should be the most vigilant.
Common Symptoms of a Displaced IUD
While the last thing you want after just having your IUD inserted is for it to shift, it can happen. Fortunately, there are a few warning signs you can watch out for that will give you an indication of what may have happened. If you notice any of the following, call your healthcare provider as soon as possible:
- Unusual pain or cramping: Any sudden, sharp, or persistent pelvic pain
- Heavy bleeding or spotting: Irregular periods or unexpected bleeding can be a sign
- Changes in IUD string position: Noticeable changes in the strings, such as that they feel shorter, longer, or missing
- Pain during intercourse: Could indicate the IUD has shifted or perforated the uterus
- Unexplained fatigue, dizziness, or fever: Possible signs of infection or perforation.
If you notice any severe abdominal pain or signs of infection, including a fever or foul-smelling discharge, you may be having an emergency. Your best course of action is to immediately get to a healthcare provider. You should also do this if you have a positive pregnancy test with an IUD in place as there is a greater risk of an ectopic pregnancy.
How to Check If Your IUD Has Moved
Assuming you are uncertain about whether or not your IUD has moved, you can actually handle a check all on your own:
- Wash your hands thoroughly
- Insert a clean finger into the vagina and locate the IUD strings
- If the strings feel longer, shorter, or missing, the IUD may have moved
- Always avoid pulling on the strings
The only times you shouldn’t self-check if your IUD has moved or displaced is if you are experiencing severe pain or bleeding or have obvious signs of infection. If you can’t feel the strings of your IUD, avoid panicking. They can sometimes curl around the cervix and it may not be a major cause fo alarm. Simply schedule an appointment with your healthcare provider as soon as possible for confirmation and give them the information from your self-check so that they can determine how soon your appointment should occur.
What to Do If Your IUD Has Moved
In the unlikely event that your IUD actually has moved, you should start by calling your doctor immediately. They will be able to confirm if it is still properly positioned, but this may require a pelvic exam or ultrasound. You should also avoid having intercourse until you have been checked by your doctor, as the IUD may not be providing effective contraception if it has indeed moved.
Never attempt to reposition or remove the IUD it by yourself, as this can cause serious injuries or complications if done improperly. A doctor will make the decision to remove or adjust it as necessary based on where it has shifted to in or around your uterus. During this process, you should also discuss your options with your doctor. If the displacement is severe, then maybe removal and replacement are the next best option. If this has happened before, though, there may be an underlying issue that needs to be explored, including alternative contraception.
When to Consider a Different Birth Control Option
As alluded to, if your IUD has shifted more than once, it may be a sign that your body is naturally expelling the IUD. Those who are on the younger side run a greater risk of IUD expulsion as well, which only complicates the matter. If you notice you have frequent pain or discomfort, then IUDs may also not be right for you as they are not meant to cause ongoing pain after the initial adjustment. Birth control pills, implants, patches, or hormonal injections are all alternatives that you can consider.
Seek out medical help as needed for your IUD
IUDs are an effective form of birth control, but they are not without their downsides. Given the risk of IUD expulsion or shifting, all women should learn to recognize the warning signs of displacement, given the risk of injury or complications that can come from such an event. In the absence of any serious symptoms, always self-diagnose to see if a shift has happened, but never hesitate to reach out to your doctor to get a full examination done to ensure nothing is amiss. If you think an IUD has been giving you too many issues then also don’t hesitate to speak to your medical provider about switching to a different form of contraception to give your body some reprieve.
