If your intrauterine device (IUD) falls out, don’t try to put it back in. Contact your healthcare provider right away, and use a backup form of birth control when you have sex.
What Is an IUD?
An IUD is a small, T-shaped device designed to provide long-term and effective birth control. It sits in your uterus and prevents you from getting pregnant by either stopping ovulation or keeping sperm from reaching your eggs. There are two types of IUDs:
- Hormonal IUDs that release progestin. These take a week to prevent pregnancy after being inserted and typically last three to five years.
- Copper IUDs, which start working immediately after being inserted and can remain effective for up to 10 years.
Your local medical provider will place the IUD in your uterus. After it’s been properly inserted, you and your partner won’t be able to feel it, and you won’t need to take any additional steps to prevent pregnancy when having sex. It’s a safe and effective form of birth control for women who want a long-term, low-maintenance contraceptive. Once your IUD is inserted, you can forget about it until you want to have it removed.
Getting an IUD
Getting an IUD is a quick and easy procedure performed by your local medical provider, often during your period, when the cervix is more open, relaxed, and sitting lower in your body. The process typically lasts five to 15 minutes. During this time, the healthcare provider will insert a speculum into your vagina (as if you were getting a Pap smear) to visualize and access the cervix, then carefully insert the IUD through the cervix and into the uterus.
At this point, two strings attached to the end of the IUD should be hanging in your vagina, which your medical provider will trim to the appropriate length. These indicate that the IUD is in the right place. They’re also how your provider will remove the device when you decide its time.
Many women experience mild discomfort and cramping during and after the IUD insertion process. Taking an over-the-counter pain reliever before the procedure and asking your provider for a numbing medication can help if you have a low pain tolerance.
Reasons an IUD Might Fall Out
In most cases, you won’t be able to feel the IUD in your uterus, and it can remain in your body for years. In rare cases, however, it might move, start to slip out of the uterus, or fall out completely. This is most common in women who:
- Are under the age of 20.
- Haven’t been pregnant.
- Recently gave birth.
- Have had an abortion.
- Often experience heavy, painful, or prolonged periods.
- Are currently on their period.
Medical providers don’t always know why IUDs get expelled. They do, however, know it’s not associated with activities such as exercise, having sex, or going to the bathroom.
How to Check Your IUD
You can check your IUD to make sure it’s still in the right place and isn’t starting to slip out by feeling for its strings. Once a month, between periods, follow these steps:
- Wash your hands.
- Get in a squatting or sitting position.
- Slide one finger into your vagina until it touches your cervix.
- Feel for the two strings hanging through the cervix into your vagina.
Your healthcare provider can show you how to do this when you have the IUD inserted. As you check your strings regularly, you’ll become familiar with what feels normal. Signs that your IUD has moved, is starting to slip out, or has been expelled include:
- Shorter strings than normal.
- Longer strings than normal.
- You can’t find the strings.
- You can feel the IUD against your cervix.
If your IUD has moved, don’t try to push it back into your uterus. Other signs that your IUD has shifted or fallen out include:
- Pain and discomfort.
- Severe cramps.
- Heavy or abnormal bleeding.
- Unusual vaginal discharge.
- Fever, if it has caused an infection.
Sometimes, however, an IUD can become partially or fully expelled without the woman realizing it.
What to Do If Your IUD Falls Out
While IUD expulsion is rare, if it does occur, contact your healthcare provider right away. Even if the IUD has only been partially expelled, you’ll need to have it removed and reinserted. You’ll also need to use backup birth control, such as condoms, during sex because it’s possible to get pregnant after your IUD has been partially or completely expelled.
You can discuss with your medical provider whether you should have another IUD inserted or explore other types of birth control, such as:
- The pill, which you must remember to take daily.
- The patch, which you must replace weekly.
- The ring, which you wear for three weeks at a time.
- The shot, which you must get every three months.
- Barrier methods such as male or female condoms, diaphragms, and cervical caps.
While all these types of birth control are effective, remember that only condoms can prevent you from getting sexually transmitted infections (STIs).
Other Side Effects of IUDs
In addition to the slight risk of your IUD falling out, you should understand the other possible side effects associated with this device, including:
- Cramping or backaches for days, weeks, or months after insertion.
- Irregular bleeding or spotting after insertion.
- Longer and heavier periods.
- Premenstrual syndrome symptoms such as acne, tender breasts, and headaches.
- Pelvic infection.
- Rarely, perforation of the side of the uterus.
IUDs also don’t protect against STIs. They remain, however, one of the most effective forms of birth control.