IUD removal is a quick office procedure that takes less than 30 seconds in most cases and is significantly less painful than insertion. A healthcare provider uses a speculum and a small tool to grasp the IUD’s strings and gently pull it out. No anesthesia is typically needed, and you can drive yourself home afterward.
What Happens During the Procedure
The process is straightforward. You’ll lie on an exam table in the same position as a pelvic exam or Pap smear. Your provider inserts a speculum to open the vaginal walls and locate the IUD strings, which hang just past the cervix. Using ring forceps (a small grasping tool), they firmly grip the strings and pull with steady traction away from the cervix. The IUD’s flexible arms fold upward as it slides through the cervical opening, and the whole thing comes out in one smooth motion.
That’s it. The active part of the removal, from grasping the strings to having the IUD in hand, often takes just a few seconds. The entire appointment, including getting positioned and having the speculum placed, rarely lasts more than a few minutes.
How Much It Hurts
Most people feel a brief cramp as the IUD passes through the cervix, similar to a strong menstrual cramp. It fades quickly. Compared to insertion, which involves steadying the cervix, measuring the uterus, and placing the device (typically three distinct intense cramps), removal is considerably milder. Some people feel almost nothing.
You don’t usually need pain medication beforehand, though taking an over-the-counter pain reliever an hour before the appointment can help if you’re anxious about discomfort.
Timing Your Removal
You can have an IUD removed at any point in your menstrual cycle, but scheduling it during your period can make things slightly easier. The cervix naturally sits lower and opens a bit wider during menstruation, which means less resistance as the device comes out. That said, removal is simple enough that most providers will do it whenever you come in.
If you want a new IUD, it can be placed in the same visit, immediately after the old one comes out. There’s no required waiting period between removal and reinsertion as long as there are no complications.
Recovery and What to Expect Afterward
Mild cramping for a few minutes after the procedure is normal, and light spotting can last a few days. Most people go right back to their regular activities the same day. These symptoms typically resolve on their own without any treatment.
If you had a hormonal IUD, your body will begin adjusting to the absence of the hormone it was releasing. Your period may take a cycle or two to settle into its natural pattern, but this varies from person to person. With a copper IUD, there’s no hormonal shift, so any changes you notice will be related to the physical removal itself rather than a chemical adjustment.
Contact your provider if you develop a fever over 101°F, heavier than usual bleeding, or severe pain. These are uncommon but worth watching for in the first day or two.
When Removal Gets Complicated
Occasionally, a provider meets resistance when pulling on the strings. This can happen if the IUD has become embedded in the uterine lining. When the device doesn’t move with gentle traction, the provider will stop and investigate rather than force it. A deeply embedded IUD may need to be removed using a hysteroscope, a thin camera inserted through the cervix that lets the provider see exactly where the device is and carefully free it. This is a more involved procedure but still typically outpatient.
If the strings aren’t visible at all (they sometimes curl up into the cervical canal or get trimmed too short), the provider may use a thin instrument to locate and retrieve them. In rare cases, an ultrasound helps confirm the IUD’s position before attempting removal.
Fertility After Removal
Your ability to get pregnant returns almost immediately after an IUD comes out, regardless of whether you had a hormonal or copper device. You can try to conceive in the very first cycle after removal. A 2018 review of nearly 15,000 women found that 83% were able to get pregnant within 12 months of stopping contraception, including IUD users. The duration of IUD use didn’t negatively affect fertility either, so even years of use don’t create a delay.
If you’re not planning a pregnancy, you’ll need another form of birth control right away. There’s no grace period of lingering protection once the device is out.