So you got an IUD and dealt with the insertion process (ugh). The pros? Now you don’t have to set a daily alarm to take your birth control pill, or remember to change your patch every week, or swap your ring out every month. But, truth be told, if you have an IUD, you actually aren’t completely off the hook when it comes to managing your contraceptive situation.
Quick detour. An IUD is a T-shaped device with two strings attached—you can get a nice image of what that looks like below. Here’s a rundown on how this particular method of BC finds its home: After you sit in the stirrups at your OB-GYN appointment, she uses a tool to widen your cervix, then she pushes the IUD up the birth canal and through cervix, into your uterus. Et voilà—you’re 99 percent protected against pregnancy! But! “If the IUD moves down, or if it becomes embedded or dislodged, it might not function as well or be as effective,” explains Sonia Bahlani, MD, an OB-GYN and pelvic pain specialist practicing in New York City.
For the IUD to properly do it’s one job of effectively preventing pregnancy, it’s gotta stay secure in your uterus. You can monitor that yourself by checking the thin, dangly strings—imagine fishing line—attached to it that hang past your cervix. Once you get used to having the IUD inside you, you actually might rarely think about it, so you may want to keep an eye (or a finger…sorry) on its placement, especially when it’s first implanted.
You definitely don’t have to obsessively check them. But knowing that your IUD is in place and working right can bring you some v necessary peace of mind in today’s climate. Keep on reading to learn more about where your IUD strings should be and how to make sure they’re in the right place.
Okay, so how do I safely check my IUD strings?
First thing’s first: Wash. Your. Hands. And make sure your nails are trimmed too. Try using an unscented soap so that you’re not introducing your entire vaginal ecosystem to a fragrance that could throw off your pH balance, suggests Sophia Yen, MD, an OB-GYN who’s also a clinical associate professor at Stanford Medicine and co-founder and CEO of the birth control delivery service Pandia Health.
Next, get into the butterfly position, either laying down, sitting, or standing up, like you would when taking out a tampon. Then, insert a finger into your vagina and travel pretty high up—to the top—until you reach the firm, smooth tissue of your cervix. Now, feel around for the strings—they tend to be between 1.5 to 2 inches long and “usually feel like two fishing lines,” says Dr. Yen.
If you don’t feel ’em, don’t freak out just yet. “The strings can curl up and around the cervix or be flat on it or in a place you can’t feel,” according to Dr. Yen. Of course, if you’re concerned, don’t hesitate to go see your OB-GYN to be sure everything’s okay.
But wait, do I have to check my IUD strings?
For the first three months after the insertion, your doctor may want you to check their position, because that’s when they would be most likely to come out, says Dr. Yen. After that, some doctors don’t think it’s necessary to worry about it, mainly because your OB-GYN will check the strings during your annual appointment (and if you have an issue, you can always schedule another appointment in between).
Other physicians say it can’t hurt to check your strings the entire time you have the IUD—just so you get a sense for what’s normal, says Dr. Bahlani. Get into the habit of checking more regularly by doing it after each period, when it is typically easiest to physically reach your cervix, or just once a month (if having an IUD has stopped your period). This method is all about knowing your body well and identifying regular patterns so you can note when things feel off.
I’m not sure my IUD strings are in place. What should I do?
The first thing you should *not* do is have sex, (at least not without some additional form of protection, like condoms), Dr. Yen cautions. If you have any doubts about the IUD being in place, you have unusual discharge, or are bleeding, see a doctor. “Don’t stick your fingers up your vagina if you are in pain,” Dr. Yen adds. Also, don’t try and remove the IUD yourself—just let your OB-GYN investigate.
When you book an appointment, your doc may do a sonogram to take a look at the placement of the IUD, explains Dr. Bahlani. From there, they’ll determine the best course of action, which could include removing and reinserting the device.
I’m worried my IUD might fall out. Can that actually happen?
Most of the time, no. Only 2 to 10 percent of people might have an IUD expulsion, but a copper IUD might have a higher risk of coming out, says Dr. Yen. Heavier periods can be a side effect of the non-hormonal birth control, so more bleeding might increase the chance of the IUD dislodging. Additionally, some people could have a copper allergy that creates an adverse reaction to the IUD, causing it to come out of place. The symptoms of a copper allergy might include vaginal itching and lower abdominal pain or pressure, says Dr. Bahlani, so be on the lookout for those.
Ideally, your OB-GYN should run through all of these details with you when they’re placing the IUD, like knowing about your allergies, how long your specific strings are, how to feel for the strings, and how to know if something’s out of place. If they don’t offer the info up, don’t be shy about advocating for yourself and asking questions. Staying informed about the choices you’re making for your body is more important than ever.
Mara is a freelance writer and editor specializing in culture, politics, wellness, and the intersection between them, whose print and digital work has appeared in Marie Claire, Women’s Health, Cosmopolitan, Airbnb Mag, Prevention, and more. She’s a Fordham University graduate who also has a degree in Italian Studies, so naturally she’s always daydreaming about focaccia.