Can Sexual Activity Dislodge an IUD?
A common misconception is that deep or vigorous penetrative sex can cause an intrauterine device (IUD) to shift or become dislodged. This is not true. An IUD is positioned high within the uterus, which is a muscular organ located beyond the cervix. The cervix, which has a small opening, acts as a barrier separating the uterus from the vagina. During sex, the penis and any sexual toy remain in the vaginal canal and cannot reach the IUD itself. The only part of the IUD that extends into the vaginal canal are two thin, flexible strings, which curl up and soften over time, making them difficult to feel for most partners. While a partner might feel the soft strings, they cannot grab or pull them to move the device. The IUD is designed to withstand internal uterine pressures, including sex.
If a partner reports feeling the hard plastic part of the IUD during sex, this is a sign that the device has already shifted on its own and requires medical attention.
Why IUDs Sometimes Move on Their Own
IUDs can shift or become expelled from the uterus, but this happens due to natural anatomical factors, not external forces like sex. Factors that increase the risk of spontaneous expulsion or displacement include:
- Being a teenager or under 20 years old
- Having heavy or painful periods
- Uterine contractions, especially during menstruation
- An incorrect initial IUD placement
- Placement immediately after childbirth
- Uterine abnormalities, such as fibroids or a tilted uterus
Expulsion is most likely to occur within the first few months after insertion and sometimes goes unnoticed.
How to Check if Your IUD is in Place
Regularly checking your IUD strings is the primary way to monitor for displacement. The best time to check is at the end of your period, as the cervix is lower and the strings are more accessible. You should be taught how to check your strings at your insertion appointment. Follow these steps:
- Wash your hands thoroughly: This prevents introducing bacteria into your vagina.
- Find a comfortable position: Squatting, sitting on the toilet, or standing with one leg up on a stool works well.
- Insert a clean finger: Gently insert your index or middle finger into your vagina until you touch your cervix. The cervix feels firm and rubbery, like the tip of your nose.
- Feel for the strings: The strings should feel like fine fishing line coming out of the cervix. If your IUD is in place, the string length should feel the same each time you check.
If you cannot feel the strings, or if they feel shorter, longer, or uneven, it could indicate that the IUD has shifted. In some cases, the strings may have simply curled up and are not always a sign of a problem. However, any change warrants a call to your doctor.
Key Signs of a Displaced or Expelled IUD
Beyond checking your strings, pay attention to any new or unusual symptoms, which are often the clearest indicator of a problem. If you experience one or more of the following, contact your healthcare provider:
- You or your partner can feel the IUD itself: This is the most definitive sign of partial expulsion. You should never be able to feel the hard, plastic T-shape of the device, only the soft strings.
- Severe cramping or abdominal pain: While mild cramping is normal after insertion, a sudden onset of severe or persistent cramps may indicate displacement.
- Unusual or heavy bleeding: A return to heavier periods (for those with hormonal IUDs) or increased spotting between cycles can be a sign.
- Abnormal vaginal discharge: A change in the color, consistency, or odor of your vaginal discharge, especially if accompanied by a fever, can signal an infection caused by a misplaced IUD.
- Painful intercourse: Pain during sex that was not present before is a possible symptom of displacement.
IUD Side Effects vs. Signs of Displacement: A Comparison
It is important to distinguish between normal, temporary side effects and more serious signs of a shifted IUD. This table helps clarify the difference:
| Symptom Category | Normal Side Effect | Sign of Displacement |
|---|---|---|
| Cramping | Mild to moderate cramping is common in the first few weeks after insertion and may continue with periods. | Severe, persistent, or worsening cramps, especially when combined with other symptoms. |
| Bleeding/Spotting | Irregular bleeding or spotting is common in the first 3-6 months. Periods may become lighter or stop with hormonal IUDs. | Heavy or excessive bleeding, new spotting between periods, or a return to heavy periods after they became lighter. |
| IUD Strings | Length remains consistent, though strings may soften and curl closer to the cervix, making them harder to feel. | Strings feel noticeably shorter or longer, seem uneven, or you can feel the hard plastic of the device. |
| Pain | Mild discomfort or backaches may occur in the first day or so after insertion. | New, persistent, or severe pelvic or abdominal pain. Painful intercourse that wasn't previously an issue. |
What to Do If You Suspect Your IUD Has Moved
If you have reason to believe your IUD is not in its correct position—for example, if you can't feel the strings or are experiencing any of the above symptoms—follow these steps immediately:
- Do not panic and do not try to fix it yourself. Do not pull on the strings or try to push the device back into place, as this can cause injury.
- Use a backup birth control method. Until a healthcare professional confirms your IUD is in place and effective, use condoms or another method to prevent pregnancy.
- Contact your healthcare provider. Schedule an appointment right away. They can perform an internal exam and, if necessary, an ultrasound to determine the IUD's position.
- Consider emergency contraception. If you have had unprotected sex recently and suspect your IUD has moved, ask your doctor about the need for emergency contraception.
Conclusion
The most important takeaway is that sexual activity cannot physically cause a properly placed IUD to move. Concerns about a partner's actions causing displacement stem from a misunderstanding of the IUD's position within the uterus. Instead, displacement is typically the result of natural uterine processes or other risk factors. For your own peace of mind and safety, a monthly string check is recommended, especially in the first few months after insertion. If you notice any significant changes or concerning symptoms like severe cramping, heavy bleeding, or can feel the hard part of the device, it is imperative to seek professional medical advice. A healthcare provider is the only person who can confirm your IUD's position and ensure your continued safety and contraceptive protection.
For more information on IUDs, visit the American College of Obstetricians and Gynecologists website.
