What to Expect During Your IUD Removal

Mirena, Skyla, or ParaGard IUD

Female doctor holding an IUD
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At some point, you must have your IUD removed. Why? Well, because IUDs do not dissolve and can't stay in your uterus forever. And, for the most part, they also will not come out on their own.

The good news is that you don't need to be scared to have your IUD removed. The IUD removal procedure is often easier, way less painful, and quicker than your IUD insertion.​​

I also cannot stress this enough: Even though it may be tempting, you should never try to remove your IUD by yourself.

The same goes for asking a friend (or another unqualified person) to do so because this could cause serious damage.

Indications

You may have several reasons why you would want your IUD removed. These could include:

  • a desire to become pregnant
  • side effects that you can no longer tolerate
  • developing an infection
  • simply just not liking having an IUD

Another major reason you must have your IUD removed is because it is no longer effective:

  • Mirena IUD – must be removed once you've had it for five years
  • Skyla IUD - must be removed once you've had it for three years
  • ParaGard IUD – must be removed once you've had it for 10 years

Some women believe that they need their IUD removed if they switch sexual partners. This is not true. Your IUD will continue to work just as effectively no matter how many sexual partners you have, so this is not a reason for an IUD removal.

The Procedure

An IUD can be removed at any time during your menstrual cycle.

That being said, studies have shown that it may be a little easier to remove an IUD while you are on your period. This is because your cervix is naturally softened during this time.

  1. Just like during your IUD insertion, your doctor may begin your IUD removal by determining the position of your uterus.
  1. A speculum may be inserted to separate the walls of the vagina. 
  2. Your doctor will look for your IUD strings. Then, the doctor will use forceps to securely grasp the IUD strings. Your doctor will slowly pull on the IUD strings.
  3. The flexible arms of the IUD will fold up as the IUD slides through the opening of the cervix.

And... then your IUD removal is over! It really only takes a few minutes, and it is not very painful.

Complications

For most women, an IUD removal is usually a routine and uncomplicated procedure. But in some cases, your doctor may not be able to locate your IUD strings.

If this happens, it is most likely because your strings have slipped up into the cervical canal, which can occur if they were cut too short (either when you had your IUD inserted or if you requested to have them shortened because your partner was able to feel them during sex). But, even if your IUD strings were originally cut to the recommended length, this may still happen.

So, now what? Your doctor may try to locate the strings by using an ultrasound. If they have slipped up into your cervical canal, your doctor will try to gently pull them out of your cervix with narrow forceps, tweezers, or cotton-tipped swabs.

Once the strings have been pulled out and into your vaginal canal, then the IUD removal will continue as mentioned above.

It may also be possible that the strings have gone up into the uterus. If this is the case, your doctor may use a sound (a measuring instrument) or a sonogram to make sure that the IUD is still in the uterus (and did not come out without you realizing it).

If your IUD strings cannot be located, but your doctor has confirmed that the IUD is still in place, your IUD can be removed from the uterus with forceps or tweezer-like clamps. Don't worry, though. Your doctor will be very careful to make sure that your uterus does not get injured during this process.

Serious Complications

Very rarely, an IUD may have become stuck in the uterine wall and it cannot easily be pulled out. Your doctor can use different techniques, such as ultrasound, hysterography (x-rays of the uterus after giving you a contrast medium), or hysteroscopy (direct viewing of the uterus with a fiber-optic instrument) to determine if this has taken place.

If your IUD is stuck in your uterus, your doctor may have to dilate your cervix and use forceps to remove your IUD. If this happens during your IUD removal, it is very likely that your doctor will give you a local anesthetic to help reduce any pain or discomfort.

IUD Replacement

You can easily have a new Mirena, Skyla, or ParaGard IUD inserted immediately after your old IUD is removed. This can all be done in one office visit (as long as there are no complications).

Scheduling the Procedure

When planning the day for your IUD removal, figure out if this day is near the time that you are ovulating. If you have had sex right before your IUD is removed (and you are ovulating around that time), you may be at risk for becoming pregnant.

Sperm can live inside the vagina for up to five days. So, for an example, let’s say that you are scheduled to have your IUD removed on June 12.

  • Well, you decide to have sex (one last time!) on June 10.
  • You then have your IUD removed on June 12.
  • If you ovulate on June 12, June 13, or June 14, you may become pregnant since the sperm (from your sex on June 10) can still be inside of you—just waiting to fertilize an egg.

It is probably a good idea not to have any sex (unless you also use a condom) for at least one week before your IUD removal. This will lower the chances of conception during fertile days

Also, if you decide to schedule your IUD removal at any time other than when you are on your period, talk to your doctor about starting a new birth control method seven days before your IUD is removed. This way, if you switched to a hormonal contraceptive, it will be working by the time your IUD is removed.

Source:

Whaley NS, Burke AE "Intrauterine Contraception." Womens Health (Lond). 2015 Nov;11(6):759-67.

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