Everything you need to know about IUD removal
When the IUD is no longer useful or necessary, a doctor can remove it.
The IUD is a small, T-shaped device that a doctor inserts into the uterus during a simple procedure. Another name for an IUD is an intrauterine contraception (IUC).
IUDs prevent pregnancy by releasing either copper or synthetic hormones into the female reproductive tract.
Once in place, these devices prevent pregnancy for between 3 and 10 years. Fewer than 1 in 100 IUD users become pregnant each year.
After this time, it is necessary to replace it. Not doing so increases the chance of both pregnancy and infection.
When should you remove an IUD?
The IUD is a small device that is effective for preventing unwanted pregnancy.
People can ask a doctor to remove an IUD at any time.
As an IUD is a form of birth control, the person should remove it if they want to become pregnant.
An IUD also has a limited lifespan. Copper-based IUDs prevent pregnancy for up to 12 years after insertion. They should be removed from the uterus after this time.
Hormonal-based IUDs have varying lifespans, depending on the brand. Some brands can prevent pregnancy for up to 3 years, while others work for up to 6 years.
After this, the person should ask a doctor to remove the device.
A doctor may also recommend removing the IUD if the individual experiences:
- an increase in blood pressure
- a pelvic infection
- endometritis, which is an inflammatory condition of the lining of the uterus
- endometrial or cervical cancer
If other side effects or discomfort occur, removal may be necessary.
Tips: What to expect
A qualified health professional will remove an IUD at a clinician's office.
They can do this at any time, but it is easier to do during the menstrual cycle because the cervix is softer.
Removal is relatively quick and simple, and there are not usually any complications.
Steps to remove an IUD
The doctor will pull on the strings to remove the IUD.
IUD removal may involve the following steps:
- The person lies on an examination table on their back with their feet apart or in stirrups.
- The health professional inserts a speculum to separate the vaginal walls and locate the IUD.
- Using forceps, the health professional pulls gently on a string that is attached to the device.
- The arms of the IUD will fold upward as it moves slowly out of the uterus. Once the procedure is complete, the health professional will remove the speculum.
There may be some light bleeding or cramping during or just after the process.
Some doctors may suggest taking a painkiller before removal to reduce these feelings of discomfort.
What happens next?
If the IUD needs removing because of an infection, a doctor may prescribe antibiotics or other treatments.
As long as there are no complications or infections, a new hormonal or copper IUD can immediately replace the old device.
The health professional can do this during the same office visit.
Risks and precautions
In some cases, complications may arise during removal of an IUD.
There is a small chance that the IUD will not come out easily. This may happen if the doctor cannot locate the IUD strings, possibly because someone cut them too short.
The doctor may use an ultrasound to find the strings, and they may use other medical instruments besides forceps to help remove the device from the uterus, such as a cytobrush or an IUD hook.
The IUD migrates
Very rarely, the device migrates through the uterine wall. In this case, hysteroscopic surgery may be necessary, under anesthesia.
Another option is to use ultrasound to guide the removal. A study published in 2015 concluded that this was less invasive and more cost-effective than surgery.
Another complication of IUD removal is an unplanned pregnancy that arises from sex in the days before removal.
People should discuss alternative forms of birth control with a healthcare professional before removing the device to prevent this.
When to have sex before and after removal
Your health provider can fit another IUD or give advice about other types of birth control.
It is safe to have sexual intercourse in the days before and after removing the IUD.
However, it is worth remembering that:
- female fertility may return to normal immediately after removing the IUD
- sperm can survive in the female reproductive tract for up to 5 days after intercourse
This means that pregnancy is possible if sex occurs in the days just before or just after removal, depending on when ovulation takes place.
If the person does not wish to conceive, it may be a good idea:
- not to have sex for at least 7 days before the removal
- to use other methods of birth control
If the person is switching from an IUD to oral contraceptives after removal, they should use another form of protection for 7 days until the oral contraceptive takes effect.
Types of IUD
There are two main types of IUD. One contains copper, and the others contain the female hormone, levonorgestrel (LNG).
The copper IUD is a plastic device with a copper coil on the stem and the arms. It continuously releases copper into the uterus to cause an inflammatory reaction which is toxic to sperm.
The plastic UID is a hormonal device that releases the hormone levonorgestrel. This thickens the cervical mucus and stops sperm from fertilizing the egg.
Levonorgestrel may also thin the uterine lining, and this can partly prevent ovulation.
Other forms of birth control
Apart from the IUD, other forms of contraception can prevent pregnancy.
Mechanical barriers physically prevent the sperm from reaching the egg. A person may combine their use with spermicide to kill the sperm chemically.
Barrier forms of birth control include:
- male and female condoms
- contraceptive sponges
- cervical caps
- Lea contraceptives
Hormonal birth control
These methods release synthetic hormones such as estrogen and progestin into the female body.
- vaginal rings
- birth control pills, patches, or injections
Sterilization is a permanent form of birth control.
For women, a surgeon will cut or seal the fallopian tubes.
For men, the surgeon will cut or block the tubes through which sperm pass. This is a vasectomy.
In some cases, it is possible to reverse a sterilization procedure, but there is no guarantee that fertility will return to normal.
What happens if you don't remove an IUD in time?
If your IUD is left in your uterus past the expiration date, the most serious danger would be infection. Serious infections can cause infertility. The other risk is that an expired IUD will not be an effective birth control method.Debra Sullivan, PhD, MSN, RN, CNE, COI Answers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.