Let me start by saying that I am NOT trying to freak you out! The IUD is a phenomenal form of birth control that has been tried and true for decades and most of the time they work well and cause no problems. There are rare situations however, where bad things can happen to good IUDs, so buckle up and lets go!
#1). IUD expulsion:
WHY? Yes, this is a rare complication but there are times when your IUD can just fall out. Remember, your uterus is a big muscle and muscles contract (think labor pain and menstrual cramps). Sometimes the contractions are strong enough to actually push your IUD out. If this occurs, it is more likely to happen during your period.
SYMPTOMS: If your IUD falls out, you might notice extreme cramping with heavy bleeding and clots. If you stopped having periods with your IUD, you might notice that your periods come back.
WHAT SHOULD YOU DO? So how do you know if this happened? The easiest way is to check for your IUD strings. You really should be checking for your IUD strings every month (to make sure that you can feel them and to make sure that they are not longer or shorter than they have been in the past). If you can’t feel your strings, you should let your medical provider know ASAP, and be sure to use backup contraception (think condoms) until you know for sure what is going on.
#2). IUD in the wrong position:
WHY? The inside of the uterus is what is called a potential space, that means that unless there is something in it (like a baby or an IUD), the inside of the uterus is actually closed. This is how the IUD works, the walls of the uterus usually put pressure on the IUD, keeping it in place. Sometimes an IUD can shift a bit though and this can affect how well it works.
SYMPTOMS: If your IUD changes location, you might experience cramping, heavy or irregular bleeding, a poking sensation in your vagina or your partner might actually be able to feel the strings during intercourse.
WHAT SHOULD YOU DO? So how do you know if this happened? Again, the easiest way is to check the strings on the end of the IUD, something you should be doing every month. If the strings feel longer or shorter than they usually do, or if you can’t feel them at all, it might mean that the IUD has changed positions. If your strings feel different or you can’t feel them at all, use backup contraception (again, think condoms) and be sure to call your medical provider ASAP.
#3). IUD perforation
WHY? This does not happen commonly, but sometimes your IUD can perforate (put a hole) the wall of your uterus. This happens most commonly when the IUD is inserted but it can happen anytime that you have an IUD if the position shifts a bit.
SYMPTOMS: Many women with an IUD perforation experience severe cramping, irregular bleeding and again have difficulty feeling the strings on the end of the IUD.
WHAT SHOULD YOU DO? Be sure to call your medical provider ASAP! If your IUD perforates your uterus, it can actually move from the uterus into the abdomen or pelvis causing problems with other internal organs (like the intestines or your bladder). If you experience these symptoms, be sure to contact your medical provider right away. She or he will likely do a pelvic exam and order an ultrasound. If all else fails or if the IUD has perforated the uterus, a minor surgery called a laparoscopy (a camera surgery to look in the abdomen or pelvis) may be necessary.
#4). Lost IUD
WHY? Sometimes you just can’t find your IUD. Usually this is either because the strings are too short to be felt or seen (with a speculum) but sometimes it can be because the IUD has fallen out (see IUD expulsion above) or because the IUD has poked a hole in the wall of the uterus (see IUD perforation above).
SYMPTOMS: Most women with a lost IUD will not have symptoms (because the problem usually is just that the strings are too short) but you can experience irregular or heavy bleeding, cramping and of course you won’t be able to feel the strings of the IUD.
WHAT SHOULD YOU DO? If you can’t feel the strings of your IUD or if you experience irregular bleeding or cramping, be sure to call your medical provider ASAP so that he or she can take a quick peek with the speculum and if necessary order an ultrasound. And of course, use backup contraception (condoms) until you know what is going on.
#5). IUD pregnancy
WHY? Before you freak out, just know that IUD are among the most effective forms of birth control, more than 99% effective! Unfortunately, nothing is 100% effective and pregnancy can occur even with an IUD. Most IUD work by making the mucus on the cervix thick, by killing sperm and by thinning the lining of the uterus. Sometimes, even if the IUD is in the right place and doing everything that it should do, a pregnancy can still occur.
SYMPTOMS: The biggest symptom is that women who were having periods with their IUD will stop having periods. Other symptoms include cramping, heavy bleeding (even if you were not having periods before) and of course the typical symptoms of early pregnancy (fatigue, nausea, vomiting, frequent urination, breast tenderness).
WHAT TO DO? If you suspect that you might be pregnant with an IUD, you must contact your medical provider ASAP, even if a home pregnancy test is negative. You have a much higher risk of experiencing an ectopic pregnancy (pregnancy outside of the uterus, usually in the fallopian tubes), and this can potentially be life threatening. Your doctor will confirm whether or not you are pregnant (blood or pregnancy test) and then perform an ultrasound. If you have a normal pregnancy, the IUD will likely need to be removed. If you have an ectopic pregnancy, you will either need medication or surgery to treat it.
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