How to Check Your IUD Strings

Intrauterine devices (IUDs) are highly effective and long-lasting forms of contraception that offer peace of mind to millions of individuals worldwide. However, like any medical device, IUDs require proper maintenance and monitoring to ensure their effectiveness and prevent potential complications. One crucial aspect of IUD care is checking the strings regularly.

In this article, we will discuss why checking IUD strings is essential and provide a comprehensive guide for users.

Types of IUD

An IUD is a small, T-shaped plastic device that is inserted into the uterus to prevent egg fertilization. On the bottom of the IUD, there are one or two threads (depending on the brand). These go out of the uterus and exit the cervix. They are around 1–2 inches long. These threads enable you or your doctor to verify if the IUD is still in place. Additionally, they are there to allow your doctor to remove the IUD when it is time to do so.

There are two types of IUDs:

• Copper IUD. They protect from fertilization by inhibiting sperm viability. They are effective immediately after insertion.
• Hormonal IUD. They contain the hormone levonorgestrel, which increases the cervical mucus's viscosity, preventing sperm migration. They start working after a week of insertion.

Why do you need to check IUD strings?

It is important to check your IUD strings regularly. Here are some reasons:

• Confirming placement. IUD strings are a marker to ensure the device is correctly positioned within the uterus. After insertion, the strings are left protruding into the vaginal canal, allowing users to verify the IUD's presence.
• Ensuring effectiveness. By regularly examining the IUD strings, you can confirm that the device has not been expelled or dislodged. An IUD that has shifted or come out of place may have compromised contraceptive efficacy.
• Detecting complications. Checking the strings provides an opportunity to identify potential issues early on. Discomfort, pain, unusual bleeding, or changes in menstrual patterns could indicate complications like perforation, infection, or expulsion. Promptly reporting such symptoms to your healthcare provider can help prevent serious complications.

How often should you check the IUD strings?

After the insertion of an IUD, your doctor will plan another appointment to check if it is still in place after 4–6 weeks. An IUD is most likely to move out of position during the first few months after placing it into the uterus or during menstrual periods. Therefore, it is firmly advised to check every 3–4 weeks after insertion. After that, you should check if the strings are in place every 3–4 months. It is recommended to check your sanitary pads or tampons during your period for extra safety.

How to check your IUD strings

Checking the IUD strings includes these steps:

• Preparation. Before checking the strings, wash your hands thoroughly with soap and warm water to minimize the risk of infection. Find a comfortable position, such as squatting or putting one foot up on the toilet seat.
• Locating the strings. Gently insert your fingers into the vagina until you can feel the cervix. The cervix feels like a firm, rounded bump. The IUD strings should feel like thin, flexible threads emerging from the cervix. They might be looped or straight, depending on the IUD type.
• Determining if there are any changes. Firstly, confirm the presence of the strings. It could indicate a dislodged or expelled IUD if you can't feel them or they seem shorter than usual. Secondly, note any unusual changes in the length or texture of the strings, which might suggest a complication.
• Being cautious. While checking the strings, be gentle to avoid accidentally pulling on them. Tugging or removing the IUD yourself can be dangerous. If you experience any pain or resistance or have concerns about the position of the IUD, contact your healthcare provider.

IUD expulsion

The process of an IUD moving out of place is called IUD expulsion. If you notice that the IUD strings feel longer or shorter than normal, or if you are unable to feel the strings at all, the IUD may have shifted or fallen out. It is important to note that it is uncommon for your partner to feel IUD strings during intercourse.

IUD expulsion sometimes doesn’t cause any symptoms, so it can go unnoticed. However, in some cases, symptoms like cramping, unusual bleeding, discomfort, or fever appear.

If you notice any of these signs or are unsure about the placement of the IUD, it is recommended to make an appointment with your healthcare provider. Remember that your IUD won't work to prevent pregnancy if it has migrated or been ejected. You should use a backup method of birth control until your doctor's visit.

When to seek medical attention

If you experience any of the following, it is crucial to seek medical attention:

• Inability to locate the strings.
• The strings feel significantly longer or shorter than usual.
• The strings feel abnormally rigid or there is an unexpected change in texture.
• Persistent symptoms, such as abdominal pain, discomfort, unusual bleeding, fever, and change in the vaginal discharge.
• Discomfort during intercourse.
• Concerns about a potential expulsion or dislodgement.

Checking IUD strings regularly is a simple yet vital part of IUD maintenance. By doing so, you can confirm correct placement, ensure contraceptive effectiveness, and detect any complications early on. Remember to establish a routine, follow proper hygiene practices, and seek medical attention if you notice any changes or have concerns. Your healthcare provider is the best resource for guidance and support regarding IUD care.