IUD Expulsion: Is it as Scary as it Sounds?

4253230816_0e36b94e44_zReprinted with permission from Bedsider.

During the first few months of having my IUD, there were some moments of discomfort that made me wonder if the IUD was in the right place. When I went to my doctor for a follow-up exam, I talked about some of the pain I had been experiencing and my fear that the IUD had been expelled. “Oh no,” she said. “You would know.”

This would be true if it had been completely expelled, but it’s also possible for an IUD to be expelled and for its user not to be quite sure. That’s called a partial expulsion. As it turns out, the IUD can move inside the uterus depending on the time of the month. As Corinne Rocca says in her article about the Mirena IUD, “Expulsion is a fancy way of saying that an IUD has been pushed out of its ideal location at the top of the uterus. The uterus is one big muscle, so this sometimes happens.” (In fact, becoming familiar with the position of the cervix is one aspect of some fertility awareness methods.)

My follow-up visit turned out fine, but what if it hadn’t? The rates of IUD expulsion fall somewhere between .05 percent and 8 percent. There are a few different factors that can affect the possibility of expulsion, like your age and pregnancy history, how long it’s been since the IUD was inserted, and even how well your health care provider inserted the IUD in the first place. There’s a higher rate of expulsion during your period, so you’ll want to make sure to check your strings regularly. Expulsion is most likely to occur during the first three months that you have the IUD.

Think your IUD may have expelled? Here’s what to do.

1. Stay calm. It isn’t pleasant or convenient, but expulsion is a potential risk when you have an IUD inserted. If you are in a lot of pain or feeling confused, take a deep breath. Stressing out may make you feel worse and make it harder for you to stay calm enough to get the care you need.

2. Double check. Being able to feel your IUD strings is totally normal (here’s a handy how-to). But if you can feel the hard plastic protruding from your cervix, the IUD isn’t where it’s supposed to be. For some women, it may be less noticeable if the IUD has expelled. It’s definitely a good idea to make an appointment with your provider if you have any of the following symptoms: severe pain and cramping; heavy or abnormal bleeding; abnormal discharge; and/or fever. (This may also be a sign of infection.) Some discomfort in the first few days after insertion is normal, but if the pain intensifies or persists, it may be time to see your provider.

3. Take care. If you’re experiencing a lot of pain while the IUD is out of place, make sure to take extra care of yourself. Try to wait to have sex until you are able to meet with your provider. Plus, if the IUD isn’t where it’s supposed to be, you may not be protected from pregnancy. If you still want to go for it, make sure to use a back-up birth control method.

4. Call your provider. If you think your IUD is out of place, call your health care provider ASAP and ask for an appointment. You definitely want to talk to them if you have severe pain, cannot find your strings, notice the strings are shorter or longer than normal, or can feel the IUD poking out. Getting in to see your provider might not be the easiest or the most convenient, but even if you’re not totally sure your IUD has been expelled, it’s worth it to take care of your health and make sure you’re covered against accidental pregnancy. If you just had the IUD inserted, a routine check-up after six weeks is a good idea anyway to make sure everything is A-OK.

Wondering if you should try the IUD again?

For women who have had an expulsion, the chance of it happening again is a little higher, but if you think the IUD is the right method for you, it may be worth trying again. Talk with your provider about your options. You may want to try a different kind of IUD, try a different provider, or see if your provider can use extra tools to make sure the IUD is in the right place this time.

If you’ve expelled multiple times or just really aren’t up for trying again, it may be time to explore other options. Fortunately there are lots of birth control methods to choose from.

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Photo courtesy of Flickr user +mara licensed under Creative Commons 2.0

Claire-Tighe-headshot-150x150

Claire Tighe is a Chicago-based feminist and nonfiction writer. She holds a degree in Women’s and Gender Studies from Dickinson College. Her previous work has appeared at RH Reality Check, Bedsider.org, Belt Magazine, The Feminist Wire and Chicago Literati. Tweet her @ecofeminismo.

Comments

  1. Mine lasted 3 days and I had a total expulsion. $90 down I wouldn’t try it again. Gone back in the pill. I really wanted it to work though.

  2. I had a partial expulsion and had nearly the same experience. The doctor was skeptical at first, but once she took a look she confirmed my fears. I was pretty disheartened, but luckily my second try has stayed in for over two years now. Thank you for sharing this!

    • Hi Christa, thanks for this share. I have just had my IUD removed today as the doctors found it was partially expelled. I am really, really sad about it as I have tried everything else. Please do you have any advice for method of insertion the second time around (did your doctor use ultrasound the second time to help with correct positioning? Or was there anything you could advise to do or to avoid?)

  3. Great Article!
    I’m a Registered Nurse on a college campus and do a good amount of contraception counseling, just wanted to add that generally the company that manufactures the IUD (Bayer for Mirena or Skyla or TEVA for Paraguard) will replace an IUD if its expelled within the first several months of insertion so that should reduce the financial barrier to replacement !
    In Wellness
    Jennifer

    • Hi Jenn,
      Do you know if this is true for Canada as well?
      I’m paying over $400 for mine this Saturday as it is not covered by insurance fr some unknown reason, so I’m kind of worried that it will expel and I won’t want to pay for a new one.
      Thanks!

  4. I have an 8 year old son…I got my mirena when he was just 3 months old…had it changed when he was 5 years old and have had this one 3 years now..it’s never slipped and has worked like a charm…I am very happy with it and will use it over and over 🙂

  5. Angie Peck says:

    I’m experiencing a partial expulsion now. My lower back pain has become so bad I can’t bend over and now I can barely make the stairs. Feels like early labor actually. It’s Sunday night and I’m just waiting to make an appointment in the morning. Hopefully I don’t end up in the ER before then

  6. Majie Allison Siao says:

    i had my iud inserion from January 26 2017, and my 1st period was really painful .. the cramps are not as moderate as before that i didnt get iud and the bleeding is really heavy.. i got my 2nd period on april 7 after insertion, it was heavy, i felt like something came out in my vagina when i checked it it was the iud!!! that night i couldnt sleep my back pain is really intense! i called for my doctors appointment however i have to wait like 2 weeks after before i could see my physician.

  7. I got the skyla inserted 3 1/2 weeks ago. The insertion hurt and I’ve had spotting and cramping every few days since. Today I started bleeding and cramping, about 30 mins ago I went to the bathroom and started bleeding heavy and it felt like something came out. I could not see anything in the toilet due to all the blood. I’m now having some pretty bad cramps. I decided to look up some information about an IDU falling out. Through reading blogs and such I found that the IUDs have strings(which my doctor didn’t tell me about or how to check it), when I checked for strings, there was none. Going to make appointment in the morning.

  8. CrissyM says:

    I have the iud copper. I’ve had since June 1st 2015. When I got it I asked my doctor to cut the string so couldn’t feel it. Since I’ve had it, I hadn’t have really any issues. But last night my hubby was using his fingers inside me and he stopped and asked me what this was he was feeling. So I asked if it was a string and he said yes. This is the first time could feel it. And it was cut short so you couldn’t feel it. My hubby finger wasn’t in all the way, half way and he could feel the string! Ladies do you think my iud moved? It hurts when I have sex. Been hurting for at least a month and been cramping some afterwards too. Could that be why? Let me know please. It’s freaking me out some. Lol. I have 4 kids and had 1 miscarriage and don’t need another baby right now.

  9. I had my first Mirena IUD inserted in March 2016. It was great; I had no periods, no pain, nothing. But in September that same year I had sudden bleeding and horrific pain to the point I was in tears. Most strange was the tailbone pain. I had experienced anal pain with my periods before, but that was usually when trying to pass a bowel movement. This pain was constant and made it impossible to sit. I visited my GP and she ordered an ultrasound which showed the IUD had partially expelled and was sitting just above my cervix, so she removed it. The first IUD was inserted in the public hospital system (I’m in Australia), so the second time I visited a private gynaecologist whom assured me that expulsion is rare, especially months after insertion. He therefore concluded that it mustn’t have been inserted correctly the first time. He inserted the second IUD in February 2017 and again everything was great; no pain and no bleeding. But then, one night in November I became incredibly nauseous and was profusely sweating. The next morning I woke up with a pain and pressure on my cervix and I just knew the IUD had partially expelled again. I visited the ED and sure enough the IUD was sitting just above my cervix. Unfortunately, I continue to have coccyx pain and it gets to the point that I am unable to drive. I have no doubt that it was caused by the Mirena because beforehand I had no such issues.

    I will add that I have not had children and both times the Mirena was inserted while I was under General Ana. However, I was told that this would make no difference to how the Mirena would behave.

    My advice is to do broad research and not just trust the word of your doctor or the word of the manufacturer.

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