Younger women and teenagers aged 14–19 are more likely to have an IUD expulsion or displacement, and it is also more common among women who have an IUD insertion shortly after a vaginal birth or medical abortion.
A doctor will need to remove an IUD if it becomes displaced or falls partially out of the uterus.
Is an IUD likely to fall out?
An IUD can fall out if a woman is healing from a vaginal birth.
Some women are more likely than others to have a partial or full expulsion of their IUD. They include the following:
Women healing from a vaginal birth
A 2018 study of 162 women who had an IUD insertion straight after vaginal delivery found that 8 percent experienced complete IUD expulsion within 6 months, and 16 percent had a partial expulsion.
Younger women and girls
Other research shows that younger women and teenagers aged 14–19 have a higher risk of IUD expulsion. The risk decreases once a woman is over the age of 19.
Women who have recently had a medical abortion
Some evidence also suggests that it might be advisable for women who have recently had a medical abortion to delay getting an IUD.
A study published in The European Journal of Contraception & Reproductive Health Care reported that women who had an IUD insertion within 2 weeks of a medical abortion were more likely to have their IUD fall out than those who waited until at least 3 weeks after.
However, the difference was not significant. The results showed that 6.7 percent of the women who had an early insertion reported IUD expulsion within 6 months. In the delayed insertion group, 3.3 percent of women had an expulsion.
Symptoms of IUD expulsion and displacement
When a doctor places an IUD in the uterus, they will instruct the woman to note the position of the IUD's strings.
When an IUD falls out or becomes displaced, the woman may notice at least one of the following changes when checking the strings:
- shorter strings than usual
- strings that seem uneven
- strings that are out of place
- missing strings
A woman may also notice that they cannot feel their IUD.
In some cases, an IUD displacement or expulsion can also cause physical symptoms, including:
- heavy bleeding
- severe cramping
- abnormal vaginal discharge
Some women may also have signs of infection, including fever and malaise.
It is essential to make an appointment with a gynecologist if any of these symptoms present.
How does it affect the chances of pregnancy?
There is an increased risk of pregnancy if an IUD falls out.
A woman will have an increased risk of unintended pregnancy if her IUD falls out or becomes displaced.
If an IUD remains inserted during pregnancy, this could result in health issues for the woman and the baby.
There will be more chance of miscarriage and a higher risk of ectopic pregnancy.
Ectopic pregnancy is when the embryo implants outside the uterus, usually in the fallopian tubes. This is a medical emergency.
Doctors will carefully monitor women who get pregnant with an IUD due to these increased risks.
Aside from an increased risk of unintended pregnancy, a displaced or expelled IUD can lead to the following complications:
All of these complications are relatively uncommon, but if any do occur they will require medical attention.
When to see a doctor
A woman should see her doctor if she suspects an IUD expulsion or displacement. The doctor is likely to carry out a physical examination and order an ultrasound to locate the IUD.
A woman should also see a doctor if she becomes pregnant while using an IUD, as pregnancy with an IUD carries an increased risk of miscarriage and ectopic pregnancy.
Medical attention would also be necessary for a woman experiencing any of the following symptoms:
- severe cramping
- heavy bleeding
- abnormal discharge
- persistent uterine pain or discomfort
These symptoms could indicate that a displaced IUD has led to severe complications.
IUDs are a popular reversible method of birth control that a woman can use in the long term.
While they are generally safe to use, in some cases an IUD may fall out or become displaced. If this happens, it increases the chance of unintended pregnancy and other complications.
A woman who believes that her IUD has fallen out should make an appointment with her gynecologist.