What are the management options for a husband experiencing dyspareunia with an intrauterine device (IUD) in place?

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Last updated: April 8, 2025View editorial policy

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From the Guidelines

If your husband is experiencing pain during intercourse with an IUD present, I recommend first consulting with the healthcare provider who placed the IUD to assess the situation and determine the best course of action. The healthcare provider can evaluate the IUD strings and trim them shorter if necessary, as the strings poking the partner during intercourse is a common cause of discomfort 1. In the meantime, trying different sexual positions that limit deep penetration and using additional lubrication can help decrease friction and irritation.

Possible Causes and Solutions

  • The IUD strings may be poking the partner during intercourse, which can be resolved by trimming the strings shorter so they curl around the cervix rather than protruding into the vaginal canal 1.
  • The IUD may not be properly positioned, which can cause discomfort for both partners, and the healthcare provider may need to check the IUD placement 1.
  • Partial expulsion of the IUD can also cause discomfort, and the healthcare provider can assess the situation and take necessary actions 1.

Next Steps

  • If the pain persists after string trimming, the healthcare provider may need to check if the IUD is properly positioned and consider other possible causes of discomfort 1.
  • Discussing alternative contraceptive methods with the healthcare provider may be necessary if the problem continues despite interventions 1.
  • It is essential to remember that while this issue is uncomfortable, it's relatively common and typically has straightforward solutions, and consulting with a healthcare provider is the best course of action 1.

From the Research

Possible Causes of Pain with Intercourse and IUD

  • Pain with intercourse in the presence of an IUD can be caused by various factors, including the IUD itself, pelvic inflammatory disease, endometriosis, or other gynecological conditions 2, 3, 4.
  • The IUD may cause pain due to its position, size, or type, and ultrasound assessment can be useful in evaluating the IUD's position and identifying any potential issues 5.

Evaluation and Management

  • A thorough medical history, pelvic examination, and imaging studies such as ultrasound or MRI may be necessary to determine the cause of pain with intercourse in women with an IUD 5, 4.
  • If the pain is suspected to be caused by the IUD, the healthcare provider may consider repositioning or removing the IUD.
  • If the pain is caused by another gynecological condition such as endometriosis, the healthcare provider may recommend treatment for that condition 2, 3.
  • Testing for sexually transmitted infections may also be necessary, especially if the woman is at high risk or has not been tested recently 6.

Additional Considerations

  • Women with a history of pelvic pain, poor quality of life scores, or multiple fibroids may benefit from further evaluation using MRI to identify any additional findings that may be contributing to their symptoms 4.
  • The healthcare provider should consider the woman's individual risk factors and medical history when determining the best course of action for evaluating and managing pain with intercourse in the presence of an IUD.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Endometriosis: A Comprehensive Review.

Advances in anatomic pathology, 2021

Research

Ultrasound Assessment of the Intrauterine Device.

Obstetrics and gynecology clinics of North America, 2019

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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