What to Expect After IUD Removal: Ob/Gyn Experts Explain

It's nothing like getting it inserted.

Whether you have an IUD removal on the books or you're just wondering what the procedure is like, you've come to the right place. IUDs, also known as intrauterine devices, are little T-shaped instruments that reside snugly inside the uterus and ward off pregnancy with a variety of mechanisms. The hormonal kinds release levonorgestrel, a synthetic form of the hormone progestin, to prevent ovulation, thicken cervical mucus, and thin the lining of the uterus, according to the U.S. National Library of Medicine. The non-hormonal IUD releases copper ions, which are toxic to sperm.

IUDs sound like some impressive sci-fi invention, but they're real, and they're giving many people with vaginas excellent control over their reproductive futures. But after a certain point, the IUD has got to go, whether you're ready to start trying to conceive or it's just reached its time limit.

If you've been through the insertion process, which usually ranges from uncomfortable to downright painful, you might think about your IUD removal with at least a little trepidation. Good news: Chances are you've got nothing to fear. Here, ob/gyns explain exactly what to expect during and after IUD removal so you can be as prepared as possible.

When do I need to get my IUD removed?

The timeline for IUD removal varies based on the specific type of IUD and how long it works. Here’s how long hormonal IUD options are recommended for use:

  • Mirena: recommended for up to five years

  • Kyleena: recommended for up to five years

  • Liletta: recommended for up to five years

  • Skyla: recommended for up to three years

As for the copper Paragard, which doesn't use hormones? That superstar is recommended for up to 10 years of use. Remember: You can always get your IUD removed earlier than any of these benchmarks if you want to get pregnant or if you've decided another birth control option makes more sense for you.

What actually happens during IUD removal?

You know those strings hanging out of the bottom of your IUD? This is their time to shine. "The vast majority of the time, [IUD removal] involves doing a simple exam much like a Pap smear," board-certified ob/gyn Antonio Pizarro, M.D., tells SELF. "If the strings are visible, the doctor grasps them using an instrument called ring forceps and gently pulls the IUD out."

"Usually patients get really worked up, then when it's done, they say, 'Oh, that's it?'" Jacques Moritz, M.D., an ob/gyn at Weill Cornell Medicine and NewYork-Presbyterian Hospital, tells SELF. The general 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 way they do during insertion), the IUD's wings don't have to open up in your uterus (ditto), plus the IUD's arms just fold in on themselves when it's being removed, so it's as small as possible.

Is IUD removal painful?

"Anyone who has an IUD basically paid the price when getting it," Dr. Moritz says, explaining that insertion tends to be much more uncomfortable than removal. Keep in mind that even when rating the experience as terrible, many people say the pain of getting an IUD was well worth it since these devices provide such stellar protection against pregnancy.

"Everybody gets nervous about [removal], but it should almost not be felt," Dr. Moritz says. Even if it does feel uncomfortable, it should be quick: "Just one deep breath, and it’s done," Dr. Moritz adds. Can't you practically feel your uterus relaxing at this very welcome news? Even better, depending on your insurance, the cost of the removal may be covered.

Are there any IUD removal complications to know?

Most often, the whole 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, Dr. Moritz says. "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," Dr. Pizarro says. But on the off chance that something like that happens, doctors may use an ultrasound or hysteroscope (a thin lit tube that allows a doctor to see inside the uterus) to locate the IUD so they can remove it, potentially with anesthesia depending on the situation. "Even then, it's limited invasiveness," Dr. Pizarro says.

What kind of IUD removal side effects should I be prepared for?

You might feel a cramp as the doctor pulls out the IUD (again, it shouldn't feel anything like the ones some people experience during insertion) or you might not even realize it's happened, Dr. Pizarro says. Beyond that, you may experience some residual cramping after an IUD removal.

You may also be wondering, Will I experience bleeding after my IUD removal? Yes, you may experience some spotting after an IUD removal, but as long as it isn't severe and goes away in a few hours or, at worst, a couple of days, that's totally normal.

One thing to really think about is that your period may change after IUD removal depending on what kind of IUD you had and how the device influenced your cycle over time. Hormonal and non-hormonal IUDs can change periods in different ways. You might enjoy lighter, less painful periods on a hormonal IUD like Mirena—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, Dr. Moritz says.

As for the copper IUD, it's all about how your body adjusted to it over time. Copper IUDs can make periods heavier and crampier at first, but for some people, that abates, while others deal with more intense periods the entire time they have the IUD. After getting a copper IUD removed, your period might become lighter and less annoying or not change much at all, the experts explain.

Can I just remove my IUD myself?

Pulling a few strings sounds simple enough, but as SELF previously reported, pulling out an IUD is not as easy as pulling out a tampon. Sometimes some elbow grease is necessary when removing an IUD, and without medical training, you could hurt yourself. You might end up accidentally cutting yourself, for example. The bottom line? Leave IUD removal to the pros.

How long does it take to get pregnant after IUD removal?

"Fertility is possible immediately," Dr. Pizarro says. If you're not ready to have kids now or ever and liked your IUD experience, it might make sense for you to get another IUD in the same visit (you're already there, after all).

If you decide not to get a new IUD for whatever reason and you're not interested in getting pregnant, be sure to talk to your ob/gyn so you can find another reliable form of contraception.


Originally Appeared on Self