You may be able to tell if your IUD is out of place by checking the location and length of the IUD strings.

It’s rare, but an IUD can move out of place, or even fall out. If this happens, you might have to get it removed.

An intrauterine device (IUD) is a small, plastic, T-shaped device that’s put into your uterus to prevent pregnancy or for other purposes, such as for heavy periods. It’s a type of long-acting reversible contraceptive (LARC).

Depending on the type and brand of IUD, they last for 3 to 12 years. During that time, you won’t have to think about your birth control.

This article will help explain why an IUD may move, how to tell if it’s become displaced, and what to do about it.

There are two main types of IUDs:

  • copper IUDs, sold under the brand name Paragard
  • hormonal IUDs, sold under brand names such as Mirena, Kyleena, Liletta, and Skyla

Both types of IUDs work by keeping sperm from meeting and fertilizing an egg.

Copper IUDs repel sperm from the egg. Hormonal IUDs work in two ways:

  • The main way they work is by thickening your cervical mucus so that sperm can’t get through to meet an egg. They also thin the lining of your uterus, called the endometrium.
  • They may stop you from ovulating or releasing an egg. This means there’s nothing in the fallopian tubes for sperm to fertilize. However, hormonal IUDs aren’t consistent at this, so they’re not a reliable method for stopping ovulation.

If you don’t like your IUD or want to get pregnant, an IUD can be removed easily in a doctor’s office.

It’s rare for an IUD to move, but it can happen. It’s most common within the first few months after it’s inserted. An IUD may move if:

  • you have strong uterine contractions during your period
  • you have a small uterine cavity
  • your uterus has a pronounced tilt
  • your IUD is put in by a doctor who’s not experienced in the procedure

Your IUD is also more likely to move if:

  • you’re under 20 years old
  • you’re breastfeeding
  • you had the IUD put in immediately after you gave birth

IUDs have strings that hang out of your cervix, which you should be able to feel.

To make sure your IUD hasn’t moved, some experts recommend checking these strings every month after you get your period. This is because your IUD is more likely to move during your period.

How to check that your IUD is in place

  1. Wash your hands.
  2. Sit or squat so you can easily access your vagina.
  3. Put a finger into your vagina until you feel your cervix.
  4. Feel for the string ends that should come through your cervix.
  5. Avoid tugging or pulling on the strings.
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If you can feel the strings, your IUD is likely in place. If you can’t feel the strings, they feel longer or shorter than usual, or you can feel the plastic of your IUD, there’s a chance it may have moved.

However, not being able to feel the strings doesn’t mean your IUD has definitely moved. It’s more likely that the strings have coiled inside your cervix. Talk to your doctor, just in case.

If your IUD has only shifted slightly, you might not notice any signs. However, if your IUD becomes displaced, the signs and symptoms will typically include:

  • not being able to feel the IUD strings with your fingers
  • feeling the plastic of the IUD
  • your partner being able to feel your IUD during sex
  • bleeding in between periods
  • heavy vaginal bleeding
  • cramping, beyond what you normally have during your period
  • pain or soreness in your lower abdomen
  • unusual vaginal discharge

If you think your IUD has moved, don’t try to put it back in place by yourself. Instead, call your doctor or healthcare provider and make an appointment to see them as soon as possible.

Your doctor will conduct an exam and tests to see if your IUD has moved. If it has, they’ll talk to you about your options.

If you plan to have sex before seeing your doctor, use a backup method of birth control. If needed, you can also use emergency contraception.

To determine whether your IUD has moved, your doctor or healthcare provider will first use a small brush to try to find the strings inside your cervix. If they can find the strings, it’s unlikely your IUD has moved.

If they can’t find the string, they’ll do a pregnancy test. Pregnancy with an IUD can be dangerous. If necessary, your doctor can give you emergency contraceptives and a backup method of birth control.

Next, they’ll do an ultrasound to look for your IUD within your uterus. If the IUD is still in your uterus, it’s up to you and your doctor whether you should take it out or leave it in. This depends on your:

  • symptoms
  • personal preference
  • exact location of the IUD

If you got the IUD recently, it may move into place on its own after a few months.

If your IUD can’t be found using ultrasound, your doctor will do an X-ray of your abdomen and pelvis. If they find your IUD, they can remove the IUD through a laparoscopic procedure.

If you want, the IUD can be replaced immediately. If your doctor can’t find your IUD using X-ray, they may conclude that your IUD was expelled (came out). If your IUD was expelled, you and your doctor should talk about other options for birth control.

Your doctor may also be able to see your IUD in your cervix before doing an ultrasound or X-ray. If they do, this means the IUD was partially expelled and will need to be removed.

There are many birth control options to choose from. An IUD has many benefits, but it may not be the right choice for you.

Let’s look at some of the pros and cons of an IUD.

IUD pros

  • more than 99 percent effective if used correctly
  • long-lasting, so you don’t have to think about it
  • reversible, and you can potentially get pregnant right away after taking it out
  • hormonal IUDs can make your period lighter or go away altogether and help lessen cramps and other symptoms of your period
  • copper IUD is the only non-hormonal, long-lasting type of birth control
  • less expensive over time than other types of birth control
  • privacy, with your partner only knowing you have an IUD if want them to
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IUD cons

  • more expensive upfront costs than other types of birth control
  • requires a clinic visit to put in or remove, versus over-the-counter birth control like condoms
  • insertion and removal can be painful
  • increased risk of ectopic pregnancy if you do get pregnant
  • copper IUD can cause heavier periods and make cramps worse, unlike hormonal forms of birth control
  • slightly increased risk of pelvic inflammatory disease from insertion process, though the risk goes down to baseline with continued use
  • can perforate (make a hole in) your uterus, though this is very rare
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IUDs are a very safe and effective form of birth control. Although rare, your IUD can move, which increases your risk of pregnancy and other complications.

IUD displacement is most common within the first few months after you get it put in. They also tend to move more if you have strong cramps during your period, have an extreme tilt to your uterus, or a small uterine cavity.

If you think your IUD may have moved, or you have other concerns, talk to your doctor. Never try to put an IUD back into place by yourself.