We at Bustle love giving you tips for how to tap into your sexual potential and troubleshoot when things aren’t going your way in the bedroom. But what about finding solutions to those stressful sexual health situations that inevitably crop up when you’re getting down? Emma Kaywin, a Brooklyn-based sexual health writer and activist, is here to calm your nerves and answer your questions. No gender, sexual orientation, or question is off limits, and all questions remain anonymous. This week’s topic: how to tell if your IUD moved — or if something else is wrong with it. Because sometimes you're not imagining it — there really might be something going on with it.
Q: I got a hormonal IUD placed two months ago and was super excited about it. I mean, super effective hormonal birth control I only have to think about every ten years? Thank you, modern medicine! And it wasn’t even that intense going in. I got some cramps for a couple days after and that was it! But now I’m feeling kinda off — I’m getting cramping between my periods and it hurts when I have sex, which has never happened to me before. Could something be wrong? Like, could my IUD have moved or could it be infected? Should I go and see my doctor? And until then, should I stop having sex — maybe I'm not safe?
A: The IUD is an excellent birth control option, particularly if you don’t want to do something every day but you still want to be extremely well-covered against pregnancy. IUDs are over 99% effective at preventing pregnancy, according to Planned Parenthood, which make them a rock-solid option if you're not up for remembering to take a pill at the same time every day.
Most people don’t have any trouble with their IUDs after their body gets used to them, but it's worth being aware of changes that happen right after placement.
"Once it’s placed, it usually stays in that same place and doesn't usually wiggle around," Dr. Mary Jane Minkin, a clinical professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the Yale University School of Medicine, tells Bustle. "We usually recommend for folks to come back after we insert an IUD in about a month or so we can check to see the strings of the IUD."
If things feel "off" before that month check-in, it's worth not dismissing it. "The insertion of the IUD can be uncomfortable just because you're sort of stretching the cervix and popping this thing into the uterus," Dr. Minkin says, but the discomfort shouldn't be debilitating. "If all of a sudden, you’re like, 'Oh my god, I'm in terrible pain' — you shouldn't be in terrible pain." A little bit of cramping is normal, but serious pain is something worth bringing to your provider as soon as you can, Dr. Minkin says.
Some IUDs do end up getting displaced (which is when it moves from where it was placed to a different part of your uterus), embedded in the sides of your uterus, or even expelled. Fortunately, this is pretty rare — expulsion happens under 10% of the time, IUDs get embedded under 1% of the time, and perforation of the uterus walls due to an embedded IUD is even rarer, Dr. Minkin previously told Women's Health.
If you think your IUD might have moved at all whatsoever, you'll definitely want to contact your gynecologist right away to check; in rare cases, displaced IUDs can puncture your uterus walls and mess with your other internal organs, which is dangerous and must be taken care of. Dr. Minkin also says that an infection could be a concern, which is why it's important to see your provider as soon as you can.
Here are the ways to know if one of these might be happening to you, so you can go to your gynecologist to get it fixed.
1. Your Strings Are Longer Or Shorter Than Before
Your IUD has a string attached to the bottom of it, which makes it easy for you to get it taken out when you’re done with it. These strings come out of your uterus, through your cervix, and into your vagina. When your doctor placed your IUD, they cut the strings so you can still feel them, but not so long that they're annoying (or at least, they should have). It's good to know how long your strings are because they tell you if your IUD is still where it's supposed to be. Checking your IUD strings is super simple — with clean hands, put your index or middle finger up into your vagina until you get to your cervix. Your IUD strings should be coming through your cervix and you should be able to feel them there.
"Your cervix sort of feels like your nose, so if you imagine that you had two threads against the tip of your nose, that's sort of what the IUD strings will feel like," Dr. Minkin says.
If you suddenly notice that your strings are longer than they were before, this is a sign that your IUD might have slipped down from where it was placed. If you notice changes in your strings, go visit your gynecologist so she can check you out. Sometimes the strings get tangled and just feel shorter, but other times you might need to get your IUD placed again.
2. Or You Can't Feel Your Strings At All
Alternately, if you can’t find your strings, this could mean that your IUD has moved further up into your uterus, dragging the strings along with it. "The major thing that I would say that people should be concerned about [is] if, for example, they can't find their strings all of a sudden," Dr. Minkin says.
3. You Can Feel The IUD In Your Cervix
This one’s pretty obvious. Your IUD is supposed to be placed up inside your uterus (here’s a picture of where it goes). Up there, you shouldn't able to feel it. If you notice your IUD is coming out of your cervix or you feel the bottom of it in your cervix, that means it’s too low and is therefore displaced — and might even be in the process of coming out completely.
Feeling an IUD in your cervix could mean literally being able to feel it with your fingers as you do a string check — or it could mean your cervix is starting to feel uncomfortable because there's a piece of plastic or metal coming out of it that shouldn't be there.
4. Your Partner Can Feel Something Up There
Sometimes you might not notice that there’s something off with your IUD, but your partner might feel the tip of it when you have sex. If your partner notices something hard coming out of your cervix, go check it out at the doctor to make sure it hasn’t slipped. You can even tell your lovers to look out for this in advance — they may be excited for such a sexy way to help you monitor your own health!
5. It Hurts When You Have Sex
Some people report that sex changes a bit after you get an IUD, with certain positions feeling a bit more painful. However, if suddenly sex starts hurting, that may be your body telling you that your IUD isn’t where it’s supposed to be. This makes sense — if your IUD has gotten itself displaced, it could have found itself in a place that can make sex more painful, such as poking out of your cervix, which is a tender spot for many folks, even without an IUD.
6. You’re Dealing With Abnormal Vaginal Discharge
Vaginal discharge is your body’s totally normal way of cleaning your vagina. However, abnormal discharge can also be a sign that your IUD has slipped and is irritating your body. If you notice that your discharge is off in color, texture, or smell and it’s not a yeast infection or one of the other reasons your discharge can get messed up, contact your doctor to see if your IUD might be the culprit.
7. You’re Bleeding More Than Usual
Your period will most likely change after you start your IUD — if you have the hormonal version, Mirena, you’ll probably start experiencing lighter (or even no) periods once your body gets used to it. In contrast, the non-hormonal copper IUD, Paragard, is known to make makes periods heavier, and lots of people experience some spotting for first couple months after they get their IUDs. However, if you notice that your bleeding is more intense than usual or you’re spotting heavily between periods, that might be because your IUD is displaced.
8. You're Suddenly Getting Really Intense Cramps
Menstrual cramps are a normal part of having a period for many people. Many people experience cramps right after they get their IUD placed, and if you choose to get the copper (non-hormonal) IUD, this form of birth control can make your cramps more intense. However, unusual cramps and pain can be a sign that your IUD is being expelled.
"Sometimes the uterus will recognize something as a foreign body ... so it'll start contracting like labor to sort of kick [the IUD] out," says Dr. Minkin. "Fortunately, that's pretty rare, but it can happen."
If you notice that your cramps are way stronger all of a sudden, or are lasting a lot longer, go visit your doctor to make sure that your IUD isn't the problem. Expulsion happens most often during the first year you have an IUD, so pay particular attention to your cramping pain levels during this time.
The Bottom Line
Most people who get IUDs have no issues whatsoever, and will enjoy up to 10 years of worry-free pregnancy protection. If your IUD does move after insertion, though, your doctor can help you out. They might pop the device back into place, or give you a new one if the first one is expelled. Once that's sorted, you can go back to living your life, however you choose to live it!
Dr. Mary Jane Minkin, MD, a clinical professor in the Department of Obstetrics, Gynecology, and Reproductive Sciences at the Yale University School of Medicine