An Intrauterine Device (IUD) is a small, T-shaped contraceptive device inserted into the uterus for long-term pregnancy prevention. This highly effective, reversible method works by preventing fertilization or implantation, depending on whether it is hormonal or copper-based. While the device itself should not be noticeable inside the uterus, the experience of having an IUD involves a range of sensations. It is important to distinguish between what is normal and what signals a potential problem.
The Immediate Experience: Sensations During and After Insertion
The insertion process causes acute, temporary sensations that are not indicative of how the IUD will feel long-term. During the procedure, the most common experience is intense cramping as the device passes through the cervix and opens inside the uterine cavity. This feeling is brief, typically lasting only a few moments while the clinician completes placement.
Immediately following the procedure, cramping similar to moderate or severe menstrual cramps is common, sometimes accompanied by backache or lightheadedness. These side effects are expected as the uterus adjusts to the new device. Over-the-counter pain relievers and a heating pad can help manage this discomfort, which usually subsides within the first 24 to 72 hours. While intermittent spotting may occur for days or weeks, severe pain persisting beyond one week requires contacting a healthcare provider.
Normal Ongoing Sensations: The Strings and Expected Discomfort
Once the initial adjustment period is complete, the only physically detectable part of the IUD should be the retrieval strings. These are thin, flexible plastic threads, often described as feeling similar to a fine fishing line. They are cut to extend slightly through the cervical opening into the upper vagina, allowing a clinician to remove the IUD when necessary.
Patients are advised to perform a string check once a month, usually after menstruation, to confirm the IUD remains correctly positioned. To do this, a clean finger is inserted until the firm cervix is located, and the strings should be felt gently curling around it. The strings should maintain a consistent length, which is an important sign the device is in the right place.
Beyond the strings, the uterus may register the device’s presence through minor discomfort, often tied to the menstrual cycle. Mild to moderate cramping during a period is normal, though this changes depending on the IUD type. Copper IUDs can initially lead to heavier periods and more intense cramping. Hormonal IUDs often cause periods to become lighter, shorter, or stop entirely over time.
Warning Signs: When Feeling Indicates a Problem
While mild discomfort is common, certain sensations indicate the IUD has shifted or that a medical issue is developing, requiring immediate attention. The most significant warning sign is the ability to feel the hard plastic or T-shape of the device itself, rather than just the soft strings. Feeling the device suggests a partial expulsion, meaning the IUD has moved down from its intended position and is no longer providing reliable contraception.
Changes in the strings also serve as a warning sign. If the strings suddenly feel much shorter than usual, they may have retracted higher into the cervical canal or uterus. Conversely, if the strings feel significantly longer, or if they are completely missing when you check for them, the IUD may be moving out of place or have been expelled. In either scenario, a backup contraceptive should be used until a healthcare provider confirms the device’s location.
Other serious symptoms requiring medical evaluation include severe, persistent pain that is worse than typical menstrual cramps and does not improve with over-the-counter medication. This can signal displacement or, in rare cases, uterine perforation. Signs of infection, such as fever, chills, and unusual or foul-smelling vaginal discharge, also require prompt medical attention.
The Partner’s Perspective: IUDs and Intimacy
The IUD is located high within the uterus, meaning a sexual partner cannot feel the device during intercourse. The only part extending into the vaginal canal are the retrieval strings. These strings typically soften and curl up around the cervix over time, making them unnoticeable to most partners.
Some partners may occasionally report feeling the strings, particularly during deep penetration. The sensation is usually described as a slight poke or brush against the skin. If the strings cause ongoing discomfort, a healthcare provider can trim them slightly shorter to minimize the tactile sensation.
If a partner feels anything hard, sharp, or plastic-like other than the thin, soft threads, this suggests the IUD has partially expelled. In this instance, sexual activity should cease, and a medical professional should be consulted immediately to check the device’s position. The IUD should not interfere with a healthy sex life, and any persistent, painful interaction should be addressed with a clinician.