Can an IUD Fall Out During Sex?


However, keep in mind that your IUD won’t necessarily be effective right out the gate. When you can start relying on your hormonal IUD for pregnancy prevention may depend on where you are in your cycle when you get it inserted and what birth control method you’re switching from. The copper IUD, on the other hand, seems to be effective immediately after insertion, according to the CDC. Still, Dr. Tanouye suggests using a backup method of birth control for the first seven days to be safe. 

Do you have to “pull out” with an IUD? 

If you’re relying on the IUD for birth control during sex with pregnancy potential, then “pulling out” (also known as the withdrawal method) won’t necessarily add to your protection. Remember, IUDs are more than 99% effective at preventing pregnancy, whereas the withdrawal method is only reported to be 78% effective, according to a study published in Contraception. Also, pulling out doesn’t protect you against sexually transmitted infections, so you should still use a condom if STIs are a concern. 

Does sex feel different after an IUD is in?

Having sex shouldn’t feel any different for you physically once you have an IUD (though it’s possible you may feel a little more confident and comfortable knowing that a highly effective birth control has your back).

Your partner, however, may notice a very slight difference. “Sometimes patients do report that their partner can feel the IUD strings during sex,” gynecologist Stacy De-Lin, M.D., associate medical director at Planned Parenthood of Southwest and Central Florida, tells SELF. If this happens, you can go back to your ob-gyn to have the strings adjusted or trimmed, but you can also just let them be since they’ll typically soften and curl up around your cervix over time. 

If you’re ever experiencing pain during sex or bleeding after sex with an IUD, it might not be related to your IUD but is still worth bringing up to your provider. These could be signs of an infection or irritation, so don’t hesitate to get it checked out. 

How common is it for an IUD to fall out? 

When we talk about an IUD “falling out,” there are actually two different events to be aware of: IUD expulsion and perforation. Fortunately, both of these situations are rare, but they can happen, so let’s talk about them. 

IUD expulsion refers to an IUD partially or fully coming out of the uterus. This could mean that it’s coming into your cervix or (even more rarely) that it comes out completely. The rate of IUD expulsion ranges from 2% to 10%, depending on the type of IUD and a variety of other factors, according to the American College of Obstetricians and Gynecologists. 

Uterine perforation refers to a hole being poked in the uterine wall (typically during the insertion process), which could provide an escape route for your IUD. This is even rarer than IUD expulsion, happening in about 1 in 1,000 cases, according to ACOG. In some of these cases the IUD can become embedded in the uterine wall, but there are rare cases of IUDs migrating through a hole in the uterine wall into the pelvis, abdomen, or even the bowel. 

Again, this is super rare, so try not to worry about your IUD falling out or sneakily wandering over to your colon. If you ever have reason to believe that your IUD isn’t where it’s supposed to be, check in with your ob-gyn who can perform an exam and possibly an ultrasound. 

What can cause an IUD to fall out? 

While it’s not clear what causes IUD expulsion or perforation, there are a few factors that seem to increase the risk. IUD expulsion is more common in people who are younger, people with uterine abnormalities, and people who get an IUD placed shortly after giving birth, according to ACOG. It’s also worth noting that expulsion typically happens within the first two months of having your IUD, Dr. Tanouye says, though it can technically happen at any time. 

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