What To Expect When You Get Your IUD Removed
Intrauterine devices are undeniably cool. Little T-shaped instruments that reside snugly inside the uterus, warding off pregnancy with a variety of mechanisms? They sound like some impressive sci-fi invention, but they’re real, and they’re giving women excellent control over their reproductive futures. But after a certain point, the IUD has got to go, whether you’re ready to start trying for a baby or it’s just reached its time limit (five years for the hormonal Mirena, three for Skyla and Liletta, which are also hormonal, and 10 for the copper ParaGard).
If you’ve been through the insertion process, which usually ranges from uncomfortable to downright painful, you might think about your future removal date with at least a little trepidation. Good news: Chances are you’ve got nothing to fear. Here, ob/gyns explain exactly what you can expect from your IUD removal, both in the moment and afterward.
Compared to insertion, the removal is basically like lolling around on a baby-free cloud of comfort.
“Anyone who has an IUD basically paid the price when getting it—the pain happens during insertion,” says Jacques Moritz, M.D., an ob/gyn at Weill Cornell Medicine and NewYork-Presbyterian Hospital. Keep in mind that even when rating the experience as terrible, many women say the pain of getting an IUD was well worth it since they provide such stellar protection against pregnancy.
“Everybody gets nervous about removal, but it should almost not be felt. Just one deep breath, and it’s done,” says Moritz. Can’t you practically feel your uterus relaxing at this very welcome news? Even better, depending on your insurance, the entire cost of the removal may be covered.
Most of the process will be pretty familiar to you.
“The vast majority of the time, it simply involves doing a simple exam much like a Pap smear,” says board-certified ob/gyn Antonio Pizarro, M.D. “If the strings are visible, the doctor grasps the strings using an instrument called ring forceps and gently pulls the IUD out.” You might feel a cramp as it happens (again, it shouldn’t feel anything like the one some women experience during insertion) or you might not even realize it’s happened. You may also experience a little bleeding after, which is nothing to worry about.
“Usually patients get really worked up, then when it’s done, they say, ‘Oh, that’s it?'” says Mortiz. The ease of removal comes down to a few major things, he explains: The doctor isn’t using an instrument to push past your cervix, the IUD’s wings don’t have to open up in your uterus, plus the IUD’s arms just fold in on themselves when it’s being removed, so it’s as small as possible.
Most often, the process only takes a few minutes, then you’re good to go. But in the rare case that the doctor can’t find the strings, removal becomes a bit more involved.
The IUD strings can shift a bit, sometimes curling up around the cervix so they’re harder to access, or maybe they were cut too short in the first place. In those instances, doctors can try to “tease” them out using some instruments, and it won’t exactly feel pleasant, says Moritz. “It’s not super painful, but definitely uncomfortable,” he explains. He gives himself a cutoff of 10-15 minutes to try teasing the IUD out. If that doesn’t work, other measures will.
“Rarely do IUDs become dislodged or the strings get lost,” says Pizarro. But on the off chance that something like that happens, doctors may use an ultrasound or hysteroscope camera to locate the IUD so they can remove it, potentially with anesthesia depending on the situation. “Even then, it’s limited invasiveness,” says Pizarro.
The way your period may change after removal depends on what kind of IUD you had and how the device changed your cycle over time.
Hormonal and non-hormonal IUDs change periods in different ways. You might enjoy lighter, less painful periods on a hormonal IUD—or they may stop completely. So, when you get a hormonal IUD removed, your period will probably revert to what it was like without hormones, says Moritz.
As for the copper IUD, it’s all about how your body adjusted to it over time. Copper IUDs can indeed make periods heavier and crampier at first, but for some women, that abates, while others deal with more intense periods the entire time. After getting a copper IUD removed, your period might become lighter and less annoying or not change much at all, the experts explain.
You can usually get another IUD inserted right after the old one is removed.
If your removal was normal, it’s often easier both time-wise and mindset-wise to get another one placed in the same visit. But if you decide not to get a new IUD for whatever reason, “fertility is possible immediately,” says Pizarro. If you’re not ready to have kids yet, make sure to find another solid form of contraception you can rely on, like the Nexplanon implant, NuvaRing, or the Pill.