From the Guidelines
If you suspect your IUD has been displaced, contact your healthcare provider immediately for an evaluation, as displacement can lead to increased risk of pregnancy, infection, and other complications 1. When an IUD is displaced, it may cause symptoms such as abnormal bleeding or cramping, pain during intercourse, or missing IUD strings.
- Key symptoms of IUD displacement include:
- Feeling the IUD's plastic stem in the vagina
- Abnormal bleeding or cramping
- Pain during intercourse
- Missing IUD strings To diagnose IUD displacement, a healthcare provider will likely perform a physical examination and possibly an ultrasound to determine the IUD's position 1. Treatment for IUD displacement typically involves removal of the displaced IUD, and possibly replacement with a new one, as well as counseling on alternative contraceptive methods and initiation of another method if desired 1. While waiting for a medical appointment, it is essential to use backup contraception, such as condoms, to prevent pregnancy.
- Risk factors for IUD displacement include:
- Insertion immediately after childbirth
- Inexperienced providers
- Abnormal uterine anatomy According to the 2024 U.S. Selected Practice Recommendations for Contraceptive Use, if a patient desires removal or discontinuation of the IUD, the method should be removed, and alternative contraceptive methods should be offered 1.
From the Research
Symptoms of Intrauterine Device (IUD) Displacement
- Pain is a common symptom, presented by about half of the patients 2
- A third of the patients are completely asymptomatic 2
- Other symptoms may include abdominal pain, dyspareunia, and urinary symptoms 3, 4, 5
- Missing strings during gynecologic examination can be a sign of IUD expulsion 6
Treatment Options for IUD Displacement
- Laparoscopy is the preferred method for removing a migrated IUD 2, 6, 5
- Endoscopy can be an effective approach for removing migrated IUDs, especially when the device is located in the stomach, rectum, or bladder 3, 4
- Hysteroscopy can be used to remove IUDs that have perforated the uterus or bladder 3, 5
- In some cases, laparotomy may be necessary, especially when serious adhesions coexist 5
- Removal of the migrated IUD is necessary to prevent severe complications, and it is usually performed without lasting injuries 2, 6, 3, 4, 5