What to Expect When You Remove Your IUD
Intrauterine devices (IUDs) don’t work forever and aren’t supposed to: They’re designed to be easily removed if the user wants to switch to a different kind of birth control or stop contraception altogether to try to get pregnant. Regardless of your reasons for doing so, removing an IUD is typically a simple process. Knowing what to expect during and after the procedure can help you have the smoothest possible experience.
An IUD is a T-shaped contraceptive unit inserted at the base of the uterus. There are two types—hormonal and copper—and at more than 99 percent effective, IUDs are the most reliable form of birth control (besides abstinence). While the two types work differently to prevent pregnancy, insertion and removal of the products are virtually the same.
When to get it removed
Depending on the type and brand, IUDs are effective for three to 10 years. So you don't accidentally become pregnant, make sure to get your IUD removed by the expiration date.
Besides trying to have a baby, you may have other reasons to have your IUD removed, such as deciding to switch your birth control method or for relief from adverse side effects of the device. If you experience certain health problems such as a pelvic infection, endometrial or cervical cancer, you should have your IUD removed, too. Doctors will also remove your IUD if it breaks or moves out of the uterus and—though rare—if you become pregnant. Once you hit menopause, your IUD should be removed since you'll no longer need contraception.
How removal works
IUD removal is typically a quick and simple procedure with less discomfort than insertion. When scheduling your appointment, be aware that removal is easiest when the cervix is soft, which typically happens around your period.
You will lie on your back on the exam table, and your doctor will use forceps to pull on the string that hangs down from the unit into your cervix. Applying a gentle tug causes the arms of the T-shaped device to bend upward, allowing the IUD to easily slide out through your vagina. Mild cramping and/or light bleeding is common. If you’re getting your IUD removed only because it has expired, it can typically be replaced with a new one at the same time. It's a time-saving step to plan this with your doctor before the appointment.
In rare cases, an IUD won’t come out easily. Your doctor may be unable to locate the strings or the unit may have become implanted in the uterine wall. If your IUD is not embedded in the wall of your uterus, a guided ultrasound removal is a minimally invasive and less expensive procedure, plus it can be done by a clinician in the office without a hospital visit. If your doctor can't see the strings of your IUD, a pelvic ultrasound would be needed to locate the device.
If ultrasounds can't help your doctor remove your IUD, a hysteroscopy is performed by widening the cervix and inserting a thin, lighted camera. This procedure may require anesthesia and can take anywhere from five minutes to an hour. While more invasive than a guided ultrasound removal, this avoids complications of an operation. Surgery for IUD removal is very rare.
What to expect after removal
You may have light spotting, bleeding or cramping after removal. If you don’t have your IUD immediately replaced with a new one, side effects from your IUD removal will disappear—along with your effective birth control. Women who want to get pregnant can start trying right away. If you don’t want to get pregnant, you should immediately begin using some other kind of contraception.
Tips for a good experience
Don’t ever try to remove your IUD yourself. This could lead to infection or serious complications. Ask your doctor how to feel for the string so you can routinely make sure your IUD is in the proper place as this can help ensure easy removal when appropriate.
Keep in mind that sperm can live in the cervix for up to five days. If you don’t want to get pregnant, abstain from sex for the week before IUD removal or have another birth control method lined up—another IUD or an alternative method—to begin immediately. Remember, too, oral contraceptives require up to a week to take effect. Talk to your doctor to make sure you’re protected.