Until the IUD is back in place, they should use other forms of birth control. If a person who cannot find their IUD strings experiences other symptoms or signs, they may have a problem, such as a perforation or infection. To locate missing IUD strings, the doctor will usually start by performing a pelvic exam. During the exam, they may use either a colposcope or a cytobrush. A colposcope is a magnifying instrument that helps doctors look closely at the cervix, while a cytobrush is a long cotton swab that healthcare professionals often use during a Pap smear.
If the doctor cannot locate the IUD using these methods, they may use an ultrasound device to search for it. If they cannot find the IUD with an ultrasound, the IUD may have discharged from the vagina without the person noticing. The doctor is likely to order an X-ray to make sure that the IUD did not penetrate the uterus. If the doctor finds the IUD in place, there is nothing else that they will need to do unless the person does not want it there anymore.
If this is the case, the doctor can remove the IUD. If the IUD is out of alignment, the doctor will remove it. Before removal, they will use misoprostol Cytotec to help dilate the cervix. The doctor may also use local numbing agents to help prevent pain in the cervix. Finally, they may provide ibuprofen or another pain reliever to help prevent cramping. Once the cervix has dilated enough, the doctor is likely to use forceps to extract the IUD.
In many cases, the doctor will insert a new IUD shortly after removing the first one. However, this is not common. The general advice is that a person should check their IUD every month to make sure that it has not fallen out fully or partially. To do this, a person should:. If the strings feel like they usually do, no further action is necessary. Anyone who suspects that their IUD has fallen out or become misplaced should use a backup form of birth control until they see their doctor.
A person should be able to feel their IUD strings when they insert their fingers into their vagina. Sometimes, the strings may be difficult to feel because they are too short or have become curled.
Occasionally, the IUD may have moved, which may lead to a return of heavier periods. Rarely, the IUD may have punctured the uterus, which can sometimes result in signs of infection, such as fever, chills, and cramping. Int J Gynaecol Obstet. The safety of intrauterine devices among young women: a systematic review. Ultrasonography of intrauterine devices.
Prabhakaran S, Chuang A. In-office retrieval of intrauterine contraceptive devices with missing strings. Migration of intrauterine devices: radiologic findings and implications for patient care. Prabhakaran, S. In office retrieval of Intrauterine contraceptive devices with missing strings. Your Privacy Rights. To change or withdraw your consent choices for VerywellHealth. At any time, you can update your settings through the "EU Privacy" link at the bottom of any page.
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Intrauterine contraception: Management of side effects and complications. Eckler K Ed. Related Articles. Perforation is very rare. It only happens in only 1. You should schedule a checkup with your doctor and use a backup form of birth control until then.
Be sure to use another form of birth control until your doctor gives the all clear. Some symptoms may point to a bigger problem, like perforation, misplacement, or infection. See your doctor right away if you begin experiencing:. They may swirl a long cotton swab or cytobrush, the brush they use to collect a Pap smear, around the vagina and into the cervix to find the strings.
First, your cervix will be dilated, or opened. This can be done with a medication called misoprostol. Your doctor may also administer a pain reliever like ibuprofen to help prevent cramping. If additional pain relief is needed during the procedure, your doctor may inject a numbing medication into your cervix or apply a topical numbing gel.
Once your cervix has dilated, your doctor will use different instruments, like clamping forceps, to reach into your uterus and remove the IUD. In most cases , you can have a new IUD inserted immediately after removal of the misplaced one. There should be just enough string hanging into your vaginal canal to feel with the tip of your fingertips. You should check for your IUD strings with a clean finger once a month. A good time to do this is the day after your period ends.
Use backup contraception and give your doctor a call. They can help you locate your strings and advise you on any next steps.
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