How Is The Iud Removed?

Getting an IUD removed is usually a quick, simple procedure that takes just a few minutes in a doctor’s office. The doctor gently pulls on the strings attached to the IUD, which causes the arms to fold up and slide out through the cervix. Most people feel only mild cramping or nothing at all, and serious complications are rare when done by a trained professional.

How Is The IUD Removed Step by Step?

The process starts the same way as a routine pelvic exam. You lie back on the exam table with your feet in stirrups. The doctor inserts a speculum to gently open the vaginal walls so they can see the cervix clearly.

Using a special instrument called a tenaculum, the doctor may hold the cervix steady. This can cause a brief pinch. Then they locate the IUD strings with forceps. The doctor pulls gently but firmly on the strings. This motion causes the T-shaped IUD arms to fold upward, and the device slides out through the cervical opening.

The entire removal takes less than a minute. Some doctors ask you to cough during removal, which can help relax the cervix and reduce discomfort. After removal, the doctor checks that the IUD is intact and fully removed.

Does IUD Removal Hurt?

Most people describe the sensation as mild to moderate cramping that lasts only a few seconds. A 2015 study published in Obstetrics & Gynecology found that about 70% of women reported pain scores of 3 or less on a 10-point scale during removal.

The level of discomfort depends on several factors. If the strings are visible and easy to grab, removal is usually quick and less painful. If the strings have retracted into the cervix or uterus, the doctor may need to use a special tool to retrieve the IUD, which can be more uncomfortable.

Taking over-the-counter ibuprofen about an hour before your appointment can help reduce cramping. Some clinics also offer numbing spray or a cervical block if you are worried about pain. Talk to your provider ahead of time if you have concerns.

What If the IUD Strings Are Missing?

Missing strings happen in about 2-10% of IUD users, according to the American College of Obstetricians and Gynecologists. This does not mean the IUD is lost or that removal will be dangerous. It usually means the strings have coiled up inside the cervix or uterus.

If your doctor cannot see or grab the strings, they will first try to retrieve them with a special brush or a thin instrument called a uterine sound. This is done in the office and takes only a few extra minutes. If that does not work, an ultrasound is used to confirm the IUD is still in the correct position inside the uterus.

In rare cases where the IUD has moved out of the uterus (perforation), removal may need to be done in an operating room with a hysteroscope. This is a thin camera that goes through the cervix to locate and remove the IUD. Perforation occurs in less than 1 in 1,000 insertions and is even rarer in removals.

Can You Remove an IUD at Home?

The CDC and all major medical organizations strongly advise against removing an IUD yourself. The strings are very thin and can break if pulled too hard. If the strings snap, the IUD may become harder for a doctor to remove later.

There is also a risk of infection. The cervix is normally a barrier that keeps bacteria out of the uterus. Pulling on the strings from home can introduce bacteria and cause pelvic inflammatory disease. A 2020 review in Contraception noted that self-removal attempts accounted for a small but real number of emergency room visits for bleeding and infection.

Some people do successfully remove their own IUDs. But the potential harm outweighs the convenience. A doctor can remove it in minutes with proper sterile technique and without risk of string breakage. If you cannot get an appointment quickly, call your clinic and explain the situation — most will fit you in for a quick removal visit.

What Happens After IUD Removal?

Fertility returns immediately. Research published in Human Reproduction found that pregnancy rates after IUD removal are the same as the general population within the first year. There is no waiting period needed to try to conceive after removal.

Bleeding or spotting for a day or two is normal. Cramping usually resolves within a few hours. If you had heavy periods before the IUD, they may return to their previous pattern within one to three cycles. Hormonal IUDs like Mirena can suppress periods, so it may take a few months for your natural cycle to regulate.

If you want a new IUD placed, many doctors can do it immediately after removing the old one in the same visit. This is called an immediate swap. A 2018 study in Contraception found that same-day replacement is safe, effective, and preferred by most patients.

Common Misconceptions About IUD Removal

A persistent myth is that IUD removal is dangerous or requires surgery. For the vast majority of people, it is an office procedure with no cutting or anesthesia needed. Another myth is that the IUD can get “stuck” inside you. While the strings can retract, the IUD itself rarely becomes embedded. A 2021 review in the Journal of Minimally Invasive Gynecology found that embedded IUDs occur in less than 1% of cases and are usually manageable with a simple office procedure.

Some people worry that removal will cause infertility. This is not supported by evidence. IUDs do not damage the uterus or fallopian tubes. The only infection risk comes from insertion, not removal, and that risk is very low — about 0.1% according to the CDC.

Another common fear is that the IUD will break during removal. Modern IUDs are designed to withstand the pulling force. The arms fold easily and the plastic is durable. Breakage during removal is extremely rare and usually involves older models no longer in use.

What to Avoid During IUD Removal

Do not schedule removal during your heaviest menstrual flow if you can avoid it. Cramping can be more intense during that time. But if you need it out, it is still safe to have it removed at any point in your cycle.

Avoid having sex or using tampons for 24-48 hours after removal if you had any bleeding or if the removal was difficult. This reduces the risk of introducing bacteria into the uterus while the cervix is slightly open.

Do not ignore signs of infection afterward. Fever, heavy bleeding, severe pain, or foul-smelling discharge are not normal. Contact your doctor immediately if any of these occur. Genuine infections after removal are very rare — about 0.1% — but they need prompt treatment.

If you are trying to conceive, do not wait. There is no medical reason to delay pregnancy after IUD removal. Your fertility returns to baseline immediately. Some people get pregnant in the same cycle as removal.