Table of ContentsView AllTable of ContentsIUD String PurposeHow to Check IUD StringsWhat They Feel LikeCommon CausesIUD Falls OutPerforationWhen to See a Provider
Table of ContentsView All
View All
Table of Contents
IUD String Purpose
How to Check IUD Strings
What They Feel Like
Common Causes
IUD Falls Out
Perforation
When to See a Provider
If you can’t feel your IUD strings, it’s possible that they’ve moved. When this happens, don’t panic. The IUD is likely still secure and working as an effective form of birth control, but there may be signs that a healthcare provider should evaluate you to be sure.
There are a few reasons why you might not be able to feel your IUD strings when you check for them. While it’s possible that the IUD has fallen out of your uterus (expulsion), the strings may have simply curled up against your cervix. Curled strings may fall back in place during your next period.
This article explains how and why your IUD strings may feel like they’re missing. It discusses what to do if you think there’s a problem with your IUD and how healthcare providers treat this issue.
Verywell / Emily Roberts
Why You Need the IUD Strings
Anintrauterine device (IUD)such asMirenaorParaGardhas two strings that hang from your cervix into your vaginal canal. The IUD strings allow your healthcare provider to pull the IUD out of your uterus when the time comes. IUD strings also allow you to check that your IUD is in place.
If you put a clean finger into your vaginal canal, you should be able to feel the tip of both IUD strings hanging from your cervix.
When you first have your IUD inserted, you should be checking for your IUD strings every few days. Keep doing so for the first few weeks. You should also check for your IUD strings between periods.
In some cases, you may be certain that your IUD has come out. This will typically happen during the first few months of IUD use. Your IUD is most likely to slip out of place during your period. Check your pads and tampons each time you remove them to be sure that your IUD has not been expelled.
What Strings Feel Like
Each IUD string is typically 1 to 2 inches long. IUD strings are made of very thin plastic that softens and may curl over time.
If you feel your IUD strings poking you, the strings may be too long or the IUD may have moved in your uterus. Either way, if you feel your IUD strings poking you, you should schedule an appointment with your healthcare provider.
What do IUD strings feel like for your partner?Your partner may be able to feel your IUD strings during intercourse. The IUD strings should not hurt them, however. If they bother you or your partner, let your healthcare provider know. The provider may be able to cut the IUD strings shorter so that your partner is less likely to feel them.
What do IUD strings feel like for your partner?
Your partner may be able to feel your IUD strings during intercourse. The IUD strings should not hurt them, however. If they bother you or your partner, let your healthcare provider know. The provider may be able to cut the IUD strings shorter so that your partner is less likely to feel them.
Common Reasons for Missing Strings
There are two very common reasons for missing IUD strings. One is that the IUD has come out of the uterus. The other is thatperforationhas occurred during IUD insertion. Another common reason for missing IUD strings is the strings get pulled up into the cervix or uterus.
Should I use backup birth control?If you experience expulsion or perforation, you will need to use a backup birth control method to protect against pregnancy. This is because the IUD will not protect you against pregnancy when it’s out of place.If your strings are missing, you should use backup birth control until you can confirm that your IUD is still in place.
Should I use backup birth control?
If you experience expulsion or perforation, you will need to use a backup birth control method to protect against pregnancy. This is because the IUD will not protect you against pregnancy when it’s out of place.If your strings are missing, you should use backup birth control until you can confirm that your IUD is still in place.
A few other reasons for missing strings include:
How Uterine Fibroids Are Treated
If your IUD strings are missing but your IUD is still in place, healthcare providers recommend an ultrasound once a year for the first few years. This is because of the higher risk that it may be expelled during that time. The images will help to make sure your IUD is still in place.
One of the reasons why you may not be able to feel your IUD strings is because your IUD has fallen out. This is called expulsion.
Signs
If your IUD has been expelled, you may not have any symptoms. Sometimes, expulsion can cause symptoms like:
Because it’s possible to have no symptoms following IUD expulsion, it’s important for you to know how to check your IUD strings. It may be the only way to tell for sure if your IUD has come loose or has moved out of place.
Risk Factors
IUD expulsion, in which the IUD comes out of the uterus, is not common. A study of 10,747 people in India found that 4% had IUD complications. Three-fourths of this group reported the problem as either expulsion or missing IUD strings.
Some of the risk factors for IUD expulsion may include:
Your risk of IUD expulsion is higher if you are under age 20, or if you’ve had it happen before. Often, there are no symptoms and the missing IUD strings are the only sign of a problem.
What to Do
If you can’t see or feel the IUD or the IUD strings, you should see your healthcare provider to make sure that your IUD has not been expelled.Use a backup birth control method until your healthcare provider can confirm that the IUD is still in place.
This means that the IUD has been pushed through the uterus wall. This can be a serious complication. Generally, though, it is quickly noted and it can be corrected right away.
Perforation is uncommon, occurring in fewer than 1 out of every 1,000 insertions. Besides being unable to feel the strings, you may also experience symptoms such as:
However, in some people, perforation does not cause any symptoms.
Although perforation isn’t common, there are some things that can put you at higher risk for this complication, including:
If you think you’re experiencing perforation, see your healthcare provider right away.
When to See a Healthcare Provider
If you cannot see or feel your IUD strings, the next step is to call your healthcare provider. They will need to perform an exam to find out why your IUD strings can’t be felt or are missing.
If it’s confirmed that the IUD is in place and you are not pregnant, then there are several ways to try to recover your IUD strings. Healthcare providers use a special brush called acytobrush. It looks like a long mascara brush and is used to try to coax out the IUD strings. This usually works.
If the cytobrush doesn’t work, there are other options. Your healthcare provider may use various tools to dilate (open) the cervix and measure your uterus. They’ll then get a precise view of the endocervical canal.This makes it possible to see if the IUD may be in the process of expulsion.
When an IUD is in the process of expulsion, the strings tend to become more visible. IUD strings can also become twisted and out of view, though. If the IUD has been partially expelled into the cervix, the healthcare provider will typically remove it. They can replace it with a new IUD at the same time.
If all of these efforts fail to locate the IUD, a healthcare provider may order X-rays of your abdomen and pelvis.If your IUD does not show up on the X-ray film, expulsion can be confirmed. At this time, you can also get a newIUD insertedif you wish.
What to Expect During Your IUD Removal
Summary
An IUD has strings on it so that you can tell that it’s still in place in your uterus. If you can’t locate your IUD strings, it may be because your IUD has been expelled and is no longer working to provide contraception.
There are other reasons why IUD strings might “go missing.” They may be twisted and bent where you can’t feel them, or the IUD itself may be rotated within the uterus.
If the IUD is missing, your healthcare provider can place a new one. If the IUD is still there but is not inserted properly, they can remove it and replace it. In most cases, an IUD problem is not serious, but you’ll need to use backup birth control until your healthcare provider confirms that your IUD is safely in place.
8 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Jatlaoui TC, Riley HEM, Curtis KM.The safety of intrauterine devices among young women: a systematic review.Contraception. 2017;95(1):17-39. doi:10.1016/j.contraception.2016.10.006Nowitzki KM, Hoimes ML, Chen B, Zheng LZ, Kim YH.Ultrasonography of intrauterine devices.Ultrasonography. 2015;34(3):183-94. doi:10.14366/usg.15010Gehani M, Pal M, Arya A, et al.Potential for improving intrauterine device (IUD) service delivery quality: results from a secondary data analysis.Gates Open Res. 2020;3:1473. doi: 10.12688/gatesopenres.12997.3Melo J, Tschann M, Soon R, Kuwahara M, Kaneshiro B.Women’s willingness and ability to feel the strings of their intrauterine device.Int J Gynaecol Obstet. 2017;137(3):309-313. doi:10.1002/ijgo.12130Gov.uk.Intrauterine contraception: uterine perforation—updated information on risk factors.Gündüz R, Ağaçayak E, Dönmez DA, Findik FM, Evsen MS, Gül T.Evaluation of patients with uterine perforation after intrauterine device placement and determination of risk factors: A retrospective case-control study.East J Med. 2022;27(2):264-71. doi:10.5505/ejm.2022.88155Kathpalia SK, Singh MK, Grewal DS.Nonpalpable intrauterine device threads: Is it a cause for worry?Med J Armed Forces India. 2017;73(1):85-87. doi:10.1016/j.mjafi.2015.05.004Devassy R, Gopalakrishnan S, Torres-de la Roche LA, Verhoeven H, De Wilde MS, De Wilde RL.The missing intrauterine device.Int J Reprod Contracept Obstet Gynecol. 2016;5(10):3588. doi:10.18203/2320-1770.ijrcog20163449Additional ReadingPocius KD, Bartz DA.Intrauterine contraception: Management of side effects and complications. UpToDate.Prabhakaran S, Chuang A.In-office retrieval of intrauterine contraceptive devices with missing strings.Contraception. 2011;83(2):102-106. doi:10.1016/j.contraception.2010.07.004
8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Jatlaoui TC, Riley HEM, Curtis KM.The safety of intrauterine devices among young women: a systematic review.Contraception. 2017;95(1):17-39. doi:10.1016/j.contraception.2016.10.006Nowitzki KM, Hoimes ML, Chen B, Zheng LZ, Kim YH.Ultrasonography of intrauterine devices.Ultrasonography. 2015;34(3):183-94. doi:10.14366/usg.15010Gehani M, Pal M, Arya A, et al.Potential for improving intrauterine device (IUD) service delivery quality: results from a secondary data analysis.Gates Open Res. 2020;3:1473. doi: 10.12688/gatesopenres.12997.3Melo J, Tschann M, Soon R, Kuwahara M, Kaneshiro B.Women’s willingness and ability to feel the strings of their intrauterine device.Int J Gynaecol Obstet. 2017;137(3):309-313. doi:10.1002/ijgo.12130Gov.uk.Intrauterine contraception: uterine perforation—updated information on risk factors.Gündüz R, Ağaçayak E, Dönmez DA, Findik FM, Evsen MS, Gül T.Evaluation of patients with uterine perforation after intrauterine device placement and determination of risk factors: A retrospective case-control study.East J Med. 2022;27(2):264-71. doi:10.5505/ejm.2022.88155Kathpalia SK, Singh MK, Grewal DS.Nonpalpable intrauterine device threads: Is it a cause for worry?Med J Armed Forces India. 2017;73(1):85-87. doi:10.1016/j.mjafi.2015.05.004Devassy R, Gopalakrishnan S, Torres-de la Roche LA, Verhoeven H, De Wilde MS, De Wilde RL.The missing intrauterine device.Int J Reprod Contracept Obstet Gynecol. 2016;5(10):3588. doi:10.18203/2320-1770.ijrcog20163449Additional ReadingPocius KD, Bartz DA.Intrauterine contraception: Management of side effects and complications. UpToDate.Prabhakaran S, Chuang A.In-office retrieval of intrauterine contraceptive devices with missing strings.Contraception. 2011;83(2):102-106. doi:10.1016/j.contraception.2010.07.004
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Jatlaoui TC, Riley HEM, Curtis KM.The safety of intrauterine devices among young women: a systematic review.Contraception. 2017;95(1):17-39. doi:10.1016/j.contraception.2016.10.006Nowitzki KM, Hoimes ML, Chen B, Zheng LZ, Kim YH.Ultrasonography of intrauterine devices.Ultrasonography. 2015;34(3):183-94. doi:10.14366/usg.15010Gehani M, Pal M, Arya A, et al.Potential for improving intrauterine device (IUD) service delivery quality: results from a secondary data analysis.Gates Open Res. 2020;3:1473. doi: 10.12688/gatesopenres.12997.3Melo J, Tschann M, Soon R, Kuwahara M, Kaneshiro B.Women’s willingness and ability to feel the strings of their intrauterine device.Int J Gynaecol Obstet. 2017;137(3):309-313. doi:10.1002/ijgo.12130Gov.uk.Intrauterine contraception: uterine perforation—updated information on risk factors.Gündüz R, Ağaçayak E, Dönmez DA, Findik FM, Evsen MS, Gül T.Evaluation of patients with uterine perforation after intrauterine device placement and determination of risk factors: A retrospective case-control study.East J Med. 2022;27(2):264-71. doi:10.5505/ejm.2022.88155Kathpalia SK, Singh MK, Grewal DS.Nonpalpable intrauterine device threads: Is it a cause for worry?Med J Armed Forces India. 2017;73(1):85-87. doi:10.1016/j.mjafi.2015.05.004Devassy R, Gopalakrishnan S, Torres-de la Roche LA, Verhoeven H, De Wilde MS, De Wilde RL.The missing intrauterine device.Int J Reprod Contracept Obstet Gynecol. 2016;5(10):3588. doi:10.18203/2320-1770.ijrcog20163449
Jatlaoui TC, Riley HEM, Curtis KM.The safety of intrauterine devices among young women: a systematic review.Contraception. 2017;95(1):17-39. doi:10.1016/j.contraception.2016.10.006
Nowitzki KM, Hoimes ML, Chen B, Zheng LZ, Kim YH.Ultrasonography of intrauterine devices.Ultrasonography. 2015;34(3):183-94. doi:10.14366/usg.15010
Gehani M, Pal M, Arya A, et al.Potential for improving intrauterine device (IUD) service delivery quality: results from a secondary data analysis.Gates Open Res. 2020;3:1473. doi: 10.12688/gatesopenres.12997.3
Melo J, Tschann M, Soon R, Kuwahara M, Kaneshiro B.Women’s willingness and ability to feel the strings of their intrauterine device.Int J Gynaecol Obstet. 2017;137(3):309-313. doi:10.1002/ijgo.12130
Gov.uk.Intrauterine contraception: uterine perforation—updated information on risk factors.
Gündüz R, Ağaçayak E, Dönmez DA, Findik FM, Evsen MS, Gül T.Evaluation of patients with uterine perforation after intrauterine device placement and determination of risk factors: A retrospective case-control study.East J Med. 2022;27(2):264-71. doi:10.5505/ejm.2022.88155
Kathpalia SK, Singh MK, Grewal DS.Nonpalpable intrauterine device threads: Is it a cause for worry?Med J Armed Forces India. 2017;73(1):85-87. doi:10.1016/j.mjafi.2015.05.004
Devassy R, Gopalakrishnan S, Torres-de la Roche LA, Verhoeven H, De Wilde MS, De Wilde RL.The missing intrauterine device.Int J Reprod Contracept Obstet Gynecol. 2016;5(10):3588. doi:10.18203/2320-1770.ijrcog20163449
Pocius KD, Bartz DA.Intrauterine contraception: Management of side effects and complications. UpToDate.Prabhakaran S, Chuang A.In-office retrieval of intrauterine contraceptive devices with missing strings.Contraception. 2011;83(2):102-106. doi:10.1016/j.contraception.2010.07.004
Pocius KD, Bartz DA.Intrauterine contraception: Management of side effects and complications. UpToDate.
Prabhakaran S, Chuang A.In-office retrieval of intrauterine contraceptive devices with missing strings.Contraception. 2011;83(2):102-106. doi:10.1016/j.contraception.2010.07.004
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