If you can’t find your IUD strings, don’t panic. There are a number of possible causes for this, and approximately 18% of women with IUDs will experience this issue. If you can no longer feel the strings, use a backup birth control method and contact your healthcare provider. Also, inform your provider of any symptoms you may have so they can determine whether or not the issue is a possible problem.
Harmless Reasons You May Not Feel You IUD Strings
During your IUD insertion, your healthcare provider will have left two, two-inch plastic strings that hang down in your vaginal canal. They are typically placed where you can feel them with your fingertips when checking. They are plenty of benign reasons why you may be unable to feel these strings when you check.
- They may be too far in your vagina
- They may have been cut short enough that they are just out of reach
- The strings may have curled upward and coiled near your cervix
- The IUD may have rotated during or after the insertion process, putting the strings out of reach
- They are hidden in the fold of vaginal tissue
In these instances, you may find that the strings return to their normal position during your next menstrual cycle.
What Issues Will Require Medical Intervention?
There are two primary issues that could result in you being unable to feel the IUD strings that will require you to have immediate medical attention.
- Expulsion: When your IUD falls out of your uterus, it is referred to as expulsion. This is a rare occurrence but can happen, typically within the first 12 months of use. While the IUD may completely come out, it can also partially expel, and you may not realize it.
- Perforation: In the event that your IUD pokes into or through the wall of your uterus, or cervix, a perforation has occurred. This is extremely rare but can require immediate medical attention.
Factors That Increase Your Risk for Expulsion
Even though IUD expulsion is considered rare, there are some risk factors that can slightly increase your chances that it may occur. Risk factors include:
- Never having given birth
- Heavy or prolonged menstrual periods
- Being under 20
- A history of painful cramping
- Insertion when postpartum, or following a second-trimester abortion
Symptoms to Watch for If You Can’t Locate Your IUD Strings
If your IUD strings cannot be found due to them being coiled up or hidden in your vaginal tissue, you should experience no other symptoms and can schedule a routine checkup to have your healthcare professionals help you locate the strings.
If you are using a hormone-releasing IUD and you notice that your periods have not become lighter or shorter, or have become heavier after having lightened for a few months, you IUD may have fallen out, and you will need to schedule an appointment to get a new one.
Symptoms of more pressing concern such as infections, misplacement, or perforation include:
- Severe, or long-term cramping
- Chills or fever
- Odor coming from your vagina
- Expelling abnormal blood or fluid from the vagina
What Can You Expect at Your Healthcare Visit?
When you see your healthcare professional, they will perform a pelvic exam to try and locate the stings. They may use a swab, or a cytobrush during the location process. If they have difficulty finding it with this method, they may magnify the area and get a closer look.
If they are unable to locate the strings using this process, they will often order an ultrasound to verify the placement of the IUD. If the IUD cannot be located, it is likely it has expelled. They may follow up with an X-ray to ensure that there was no perforation. If the IUD is not in the correct position, your healthcare provider will remove it. In most cases, you will be able to have it reinserted immediately if you choose to.
Types of IUDs
While there are multiple brands of IUDs available in the United States, there are two primary types; hormonal and copper. Copper IUDs contain no hormones but are devices wrapped in a small amount of copper and block sperm from reaching and fertilizing an egg. In addition to blocking the pathway of the sperm, sperm does not like copper and will naturally avoid it, providing a secondary form of protection. This type of IUD can prevent pregnancy for up to 12 years. Copper IUDs can also be used as emergency contraception as long as it is placed within five days after intercourse.
Hormonal IUDs release progestin into the body to help protect against pregnancy. These types of IUDs will prevent pregnancy for between three and seven years depending on the chosen brand. The hormones in the IUD work through two methods. First, it will help to thicken the mucus in the area around the cervix so that it can block and trap the sperm, preventing it from reaching the egg. It also helps prevent you from ovulating, so that there will be no egg to fertilize in the unlikely event that sperm gets through.
One of the major benefits of choosing an IUD for your birth control options is the fact that they can last for a long time, but are not permanent. If you are ready to try to get pregnant, you will have to have the IUD removed and will be able to conceive right after.
In the rare event that the IUD has perforated the wall of your uterus, you are likely to have it surgically removed at the hospital.
While your IUD strings should be able to be felt if you reach carefully inside your vaginal canal, they can sometimes be hard to locate. You should use clean fingers to check for your strings every month, and if you cannot locate them, contact your healthcare provider for information on how to proceed and continue to use backup birth control methods until they are located.