An intrauterine device (IUD) is one of the most effective forms of birth control available, but it only works if it stays in place. The most reliable way to know if your IUD has moved is to check for the strings with a clean finger. If you cannot feel the strings, or if you feel the hard plastic tip of the device itself, you should stop using backup birth control and contact your healthcare provider right away. Do not attempt to push the device back into place yourself.
Why Checking Your IUD Strings Matters
IUDs are T-shaped devices placed inside the uterus. Two thin plastic strings hang through the cervix into the upper vagina. These strings serve two purposes: they allow your provider to remove the device, and they give you a way to confirm the IUD is still positioned correctly.
When an IUD moves out of place, it is called expulsion or displacement. Expulsion happens when the uterus pushes the device out, either partially or completely. Displacement can also mean the device has shifted position within the uterus, though the strings may still be partially visible. Both situations reduce the effectiveness of the device at preventing pregnancy.
Studies show expulsion occurs in roughly 2 to 10 percent of users, with higher rates in the first year after insertion and in people who have never been pregnant. Checking your strings monthly gives you a simple way to catch a problem early.
How To Tell If Your IUD Is In Place Or Moved
The string check is your primary tool. Wash your hands thoroughly, then sit or squat in a comfortable position. Insert your index or middle finger into your vagina until you reach the cervix, which feels like a firm, round button. The strings should feel like thin fishing line or stiff thread emerging from the cervix opening.
What you are feeling for is the strings themselves, not the IUD. The strings are usually about 1 to 2 inches long. If you feel the strings, your IUD is almost certainly in place. If you cannot feel the strings at all, or if you feel a hard plastic tip, the device may have moved. A hard plastic tip means the IUD has partially expelled and is sitting in the cervical canal or lower uterus.
Do not check too frequently. Checking once a month, ideally after your period, is enough. Checking more often can cause anxiety because string position changes naturally throughout the menstrual cycle. The cervix moves up and down, and the strings may curl or tuck behind the cervix, making them temporarily hard to find.
Signs Your IUD May Have Moved
Sometimes the string check is inconclusive. You may not feel the strings but also have no other symptoms. In other cases, your body gives you clear warning signs. Pay attention to these symptoms:
- Sudden cramping or pelvic pain that is new or different from your usual period cramps
- Abnormal bleeding, including spotting between periods, heavier periods, or bleeding after sex
- Pain during intercourse
- A feeling that something is different or “not right” in your pelvis
- Your partner reports feeling the hard plastic tip during sex
None of these symptoms alone confirms displacement, but any of them combined with a failed string check warrants a call to your provider. Some people experience no symptoms at all when their IUD moves, which is why routine string checks matter even when you feel fine.
If you think you might be pregnant and cannot feel your strings, seek medical care immediately. A displaced IUD increases the risk of ectopic pregnancy, a condition where a fertilized egg implants outside the uterus. Ectopic pregnancy is a medical emergency.
What To Do If You Cannot Feel The Strings
First, do not panic. In many cases, the strings are simply curled up out of reach. Try changing your position and checking again. Some people find the strings easier to feel while squatting or standing with one foot raised on the toilet seat.
If you still cannot feel them, use backup contraception, such as condoms, until you see a healthcare provider. This is non-negotiable. You cannot know whether the IUD is still protecting you, so assume it is not.
Your provider can locate the IUD with a pelvic exam and, if needed, an ultrasound. They may also use a small brush or swab to gently retrieve the strings from the cervical canal. In many cases, the IUD is perfectly in place and the strings were just hidden. In other cases, the device has expelled and needs to be removed and possibly replaced.
Never try to push the IUD back into place or remove it yourself. Doing so can cause injury, infection, or uterine perforation. Leave all manipulation to a trained professional.
What Happens If The IUD Has Expelled
If your provider confirms the IUD has partially or fully expelled, removal is usually straightforward. For a partial expulsion, the device is gently pulled out during a pelvic exam. For a complete expulsion, the device may have fallen out without you noticing, which is why checking the strings is so important.
After expulsion, you can have a new IUD inserted immediately if you wish. Some providers recommend waiting, but immediate replacement is common and generally safe. The risk of expelling again is slightly higher after a first expulsion, though many people go on to use IUDs successfully.
If you had unprotected sex before discovering the expulsion, your provider may discuss emergency contraception. This is a time-sensitive conversation, so do not delay seeking care.
When To See A Healthcare Provider Immediately
Some situations require urgent attention, not just a scheduled appointment. Contact your provider or go to urgent care if you experience:
- Severe or worsening pelvic pain
- Heavy bleeding that soaks through a pad or tampon every hour for two or more hours
- Fever or chills, which could indicate infection
- Foul-smelling vaginal discharge
- A positive pregnancy test
These symptoms may indicate infection, uterine perforation, or ectopic pregnancy. All of these require prompt medical evaluation. Do not wait to see if symptoms improve on their own.
How Common Is IUD Displacement?
Expulsion is not rare, but it is also not the norm. Most IUD users never experience displacement. The risk is highest in the first three months after insertion, and it decreases significantly after the first year.
Certain factors increase the risk of expulsion. Heavy menstrual bleeding, a history of prior expulsion, being under 20 years old, and having never given birth vaginally are all associated with higher expulsion rates. Having an IUD placed immediately after childbirth or after an abortion also carries a slightly higher risk.
None of these risk factors mean you should avoid an IUD. They simply mean you should be diligent about monthly string checks. The benefits of IUDs — over 99 percent effectiveness, long duration of use, and reversibility — outweigh the small risk of expulsion for most people.
Frequently Asked Questions
Can my IUD move without me knowing?
Yes, complete expulsion happens without symptoms in some people. That is why monthly string checks are recommended even when you feel perfectly fine.
How often should I check my IUD strings?
Check once a month, ideally after your period ends. Checking more often is unnecessary and can cause unnecessary worry because string position shifts naturally.
Can sex move my IUD out of place?
No evidence shows that sex dislodges a properly placed IUD. If you or your partner feel the hard plastic tip during sex, the IUD has likely already moved and needs evaluation.
What does a displaced IUD feel like?
Some people feel new cramping, pain during sex, or abnormal bleeding. Others feel nothing at all. The string check is the only reliable way to know for sure.
