Most of the time, missing strings aren’t a sign of anything concerning. But this can mean that your IUD fell out or was out of position, meaning you’re not longer protected against pregnancy. It can also mean that the IUD pushed through (perforated) the uterine wall.
This article walks you through how to check your IUD strings to ensure your IUD is in correctly in place.
Checking Your IUD Strings
When your healthcare provider inserts the IUD, the device is left inside the uterus and the strings of the IUD hang out of the cervix, resting up high in the vagina.
A healthcare provider can see the strings when doing a pelvic exam, but you cannot see them during a self-check.
Here’s how to check for your IUD strings:
Wash your hands. Be sure to clean under your nails as well. Locate the cervix: While either sitting or squatting, insert your index or middle finger into your vagina until you touch the cervix. Your cervix will feel firm and rubbery, like the tip of your nose. Feel for the IUD strings: They should feel like short pieces of fishing line coming through your cervix. If you feel the strings, then your IUD is in place and should be working. Determine if the strings have moved: If the strings feel longer or shorter than the last time you checked them, your IUD may have moved. The same is true if you feel the hard part of the IUD against your cervix (the plastic or copper part shaped like a T). In either case, the IUD will need to be put back in place by your healthcare provider.
Things to Avoid
To avoid moving the IUD out of place and the potential for complications, such as infection and internal tearing:
Never try to remove or push an IUD back in if it becomes dislodged. Never pull on your IUD strings.
How Often Should You Check IUD Strings?
The first check of your IUD strings will be done by your healthcare practitioner about four to six weeks after the device is placed. Thereafter, your provider will check for your IUD strings at scheduled follow-ups.
As for checking your IUD strings yourself, you should do so once a month, between periods. (You may want to track when your period would normally be, as some people with IUDs do not bleed during menstruation.)
Since there is a greater chance that your IUD can slip out during your period, also check your pads or tampons (if applicable) to make sure that your IUD hasn’t come out.
IUDs that move out of place often do so in the first few months after insertion or during a menstrual period.
Reasons You May Not Feel Your IUD Strings
You may have difficulty finding your IUD strings for several reasons, such as:
The strings have moved: Usually, when IUD strings are missing, it just means that the strings have drawn back into the cervical canal or uterus. The strings can be easily brought back into place during a pelvic exam. Your healthcare provider will use a special tool called a cervical cytology brush to do this. IUD expulsion: IUD strings may be missing if the device partially or fully comes out of the uterus. IUD expulsion puts you at risk of becoming pregnant. The loss of an IUD doesn’t always cause symptoms. Pregnancy: The IUD is highly effective, but not perfect. In very rare instances, IUD strings can disappear due to pregnancy. Uterine perforation: A perforated uterus is a hole in the uterus. It is an uncommon but serious complication that can occur with IUD use.
What to Do if You Can’t Find Your IUD Strings
If you can’t find your IUD strings, make an appointment with your healthcare provider. In the meantime, use backup birth control.
Your healthcare provider may have you take a pregnancy test, if you haven’t already.
If your strings can’t be located during a pelvic exam, an imaging test may be ordered. A pelvic ultrasound is often used to locate the IUD (if it hasn’t been expelled).
Once the IUD is found, your healthcare provider can remove it and, if you desire, replace it with a new one.
When IUD Strings Are Too Long
There is no danger in having long IUD strings. Unless they dangle into your vagina, you won’t feel them when going about your day. A partner might feel them if they insert a penis or finger into your vagina, however.
Some say their partner’s IUD strings “poke” them. Feeling the strings may be bothersome, but it should not cause any pain and is not otherwise harmful.
IUD strings are trimmed by a healthcare practitioner after the device is placed. Here’s a look at how long they are before that is done.
You can request that they be trimmed more later on, if you desire.
Keep in mind that it’s possible that your IUD strings could be cut so short that you cannot check for them. Make sure to have your IUD checked by your healthcare provider at your regular gynecological exam.
Summary
IUDs are a safe, reliable form of birth control. However, there are risks and downsides to all methods of birth control. One of the concerns with an IUD is that they occasionally can move out of place. Routinely checking your IUD strings can help you know if your IUD has moved.
If you can’t find your IUD strings, or if the strings seem to be in a different place than the last time you checked, contact your healthcare provider to have it checked out. Never try to remove or re-insert your IUD yourself. And until you can get in to see your healthcare provider, be sure to use a backup method of birth control.
