How to Check Your IUD Strings

Ensure your IUD is in the right place

IUD
Eduardo Luzzatti BuyA/E+/Getty Images

An intrauterine device (IUD) is a long-acting form of birth control, as it can last for several years. An IUD is also reversible, which means that when a woman wants to become pregnant, she can have her doctor remove it.

While serious problems associated with having an IUD are rare, one issue that sometimes arises is that the strings of the IUD cannot be seen. In these instances, the most likely reason for the "missing strings" is that they have simply been drawn back into the cervical canal or uterus.

Often times, during a pelvic exam, a doctor can use an device called a cervical cytology brush to sweep the strings out and make them visible again. 

But in much less common instances, missing IUD strings may be due to pregnancy or something more serious like uterine perforation (a hole in the uterus) or IUD expulsion (when the intrauterine device comes out of the uterus).

With IUD expulsion, you are at risk of getting pregnant. To further complicate the issue, many women don't have any symptoms of expulsion—in other words, they may not even realize their IUD has come out. This is why checking the strings may be the only way to tell for sure if your IUD has moved out of place. 

While checking your IUD strings is not something you do everyday (your doctor will advise you on this), it's good to know what they feel like, so if something is amiss, you'll recognize the signs. And of course if you have any questions ever about your IUD, you should call your healthcare provider.

How to Check Your IUD Strings

An IUD is a small, plastic device shaped like a T that is either wrapped in copper (for example, ParaGard) or contains the hormone progestin (for example, Mirena). When your doctor inserts the IUD, the plastic device will be left inside the uterus, but the strings of the IUD (which are made of plastic threads) will fall out of the cervix, ending up high in the vaginal canal.

When checking your IUD strings, first wash your hands. Then either sit or squat, and put your index or middle finger into your vagina until you touch the cervix. It should feel firm and somewhat rubbery, like the tip of your nose.

Feel for the IUD string ends that should be coming through your cervix. If you feel the strings, then your IUD is in place and should be working.

If the strings feel longer or shorter than the last time you checked them, or if you feel the hard part of the IUD against your cervix, your IUD may have moved. In this instance, it will need to be put back in place by your doctor. It's important that you do not try to push the IUD back yourself. Also, never pull on your IUD strings—this may make it move out of place or even come out.

Finally, if you are worried your IUD moved, be sure to use a back-up birth control method, until you can get see your doctor. She may ask you to take a pregnancy test, if you have not already done this. If yoru doctor cannot locate the strings during a pelvic exam, she may order imaging tests like a pelvic ultrasound to confirm the location of the IUD (assuming it has not been expelled from the body).

How Often Should I Check for My IUD Strings?

If your IUD is going to move out of place, it will most likely happen in the first few months after your IUD is inserted or during your period.

Generally, it's best to check your IUD strings a few times a week for the first few months after you get your IUD

You should then check for your strings once a month, between periods. Because there is a greater chance that your IUD can slip out during your period, check your pads or tampons just to make sure that your IUD hasn't come out. 

Important IUD Considerations

  • If your IUD becomes partially expelled, you need to schedule an appointment to have it removed. Do not remove it yourself. 
  • Most unplanned pregnancies happen to IUD users when it slides out without them realizing it. Even though the chance of pregnancy while an IUD is in place is extremely low, if it does happen, you should have the IUD removed as soon as you are aware that you're pregnant.
  • Women who choose to be pregnant with an IUD in place must have close medical supervision throughout their pregnancy, because there is an increased risk of pelvic infection, ectopic pregnancy, miscarriage, early labor and delivery.
  • You may choose to have the IUD strings cut shorter if they can be felt by your sexual partner. Keep in mind that sometimes the IUD strings are cut so short that you may not be able to actually check for them. Make sure to have regular IUD checkups at the same time as your periodic gynecological exam.
  • Some women mistakenly believe that they need to have their IUD removed if they switch sexual partners. This is a myth. Your IUD will continue to work just as effectively regardless of how many sexual partners you have.

A Word From Verywell

While an IUD is a convenient, safe, effective, reversible, and long-term birth control method, it is not perfect. IUDs do not protect against sexually transmitted diseases, and rarely, complications may occur, like expulsion. 

With that, remain responsible and knowledgeable about your contraception and be sure to consult your doctor with any questions or even inklings that something is not right. 

Sources:

American College of Obstetrics and Gynecologists. (September 2016). Committee Opinion: Clinical Challenges of Long-Acting Reversible Contraceptive Methods

American Congress of Obstetricians and Gynecologists. (May 2016). Long-Acting Reversible Contraception (LARC): IUD and Implant

Prabhakaran S, Chuang A. In office retrieval of intrauterine contraceptive devices with missing strings. Contraception. 2011 Frb;83(2):102-6.

Continue Reading