Okay, you finally got that intrauterine device (IUD) you were thinking about, and you managed to survive the whole insertion process.
Whew. Now, you don’t have to think about it until the IUD has to be replaced (like three to 12 years from now, depending on the type)…right?
Yes, IUDs are super low-maintenance and long-lasting (that’s probably part, if not all of, the reason you got one), but some docs say you should check your IUD strings every once in a while. You know, to make sure that lil’ guy is still hanging around up there.
Which might beg the question, Uh, how?
But really, why do I have to check my IUD strings?
Here’s the deal: When you get an IUD—a tiny T-shaped device used to prevent pregnancy—your doctor inserts it through your cervix, into your uterus, where it’s meant to stay, until it’s time to get a new one (or, you know, you decide to get pregnant).
That IUD has little strings that hang down into your vagina—and they’re not just there for show. “You want to check the strings to make sure that the IUD is still in place,” says Christine Greves, M.D., a board-certified ob-gyn at the Winnie Palmer Hospital for Women and Babies.
For the record, though, that’s not necessarily mandatory, says Jessica Shepherd, M.D., an ob-gyn and director of minimally invasive gynecology at the University of Illinois at Chicago. There’s no risk to not checking those strings on the reg. Instead, it’s just a way of letting you know that it’s still there and where it should be, she says.
There is an exception to this, though: If you notice extreme changes in your cycle (like if haven’t had a period on your IUD and suddenly you get one), or you’re having pain, it’s a good idea to make sure your strings (and ultimately your IUD) are still there, Greves says. It’s rare, but 2 to 10 percent of all IUD users can experience IUD expulsion (i.e., when the IUD leaves the uterus unexpectedly), per the American College of Obstetricians and Gynecologists (ACOG)—but more on that later.
So, how do I check my IUD strings?
Sit down or squat and insert a finger into your vagina to feel for the strings. “You need to go up a little high and usually can just feel it with the tip of your finger,” Greves says. But don’t expect for your IUD strings to feel like the ones on your tampons. Instead, “it will feel like very taut dental floss,” Greves says.
One thing to remember, though: Don’t tug on those IUD strings—if the device comes out even just a little bit, you may lose protection, and your doctor may have to fully remove the IUD, according to Planned Parenthood.
You can check your strings as often as you want, but Greves generally recommends doing it once a month if you’re not having an issues.
Okay, but what if I don’t feel my IUD strings?
First of all, don’t freak out. “That doesn’t necessarily mean that it’s not there,” Shepherd says. Your IUD could have moved further up in your uterus (taking the strings with it) and you just may not be able to reach high enough in your vaginal canal to feel it, she says. “Sometimes it can also navigate back into the cervical canal,” she adds—you won’t be able to feel it there, either. Neither of those situations are worrisome—as long as the IUD is still in your uterus, you’re still protected.
Sometimes, though, not feeling your IUD strings can mean the IUD fell out (and you may not have noticed)—which can put you at risk for unintended pregnancies, since you’re no longer protected.
And, in very rare circumstances, not feeling your IUD strings can mean the IUD perforated your uterus—meaning it pierced through your uterine wall and is hanging out somewhere in your body it’s not supposed to. This, however, only happens in about one in 1,000 IUD placements, and isn’t necessarily harmful to the body—though the IUD will have to be removed by a doctor, per ACOG.
Either way, if you’re worried about your IUD placement, call your doctor. They’ll likely do an exam with a speculum, see if the strings are there, and be able to make an informed decision on what to do next if they’re not, says Shepherd.
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