IUD Removal

Quick and usually easy.

Removing IUDs is an easy procedure that can be done in a clinician’s office and usually involves minimal pain.

Though insertions typically take less than 3 minutes with minimal cramping, removing an IUD is very easy. To prepare for your appointment there are a few things to consider:

1. Think about whether you want to become pregnant! IUDs are extremely effective birth control and a woman’s fertility resumes immediately after the IUD is removed, so if you don’t want to become pregnant, be sure to have a plan for contraception.
2. If a woman is prone to cramping or has more pain with her periods, she can take an Over the Counter pain reliever 1-2 hours ahead of time such as Aleve or Advil. 
3. An IUD can be removed at any time during the menstrual cycle. It’s slightly easier during a period, but not by enough to ask a woman to wait. Also, around 40% or more of women who use Mirena or Liletta progesterone containing IUDs don’t have a period. This is normal, expected and safe—it’s because the progesterone in the IUD causes the endometrial lining in the uterus to be very thin and so there isn’t blood or tissue that needs to come out.
4.  The prep for how a woman should prepare does not differ if she has a copper-containing or a progesterone-containing IUD. 
5.  It takes longer for a woman to have her Blood pressure checked than it does to remove the IUD.  Once she is lying down in the same position she would be in to have a pelvic exam, I find the strings that come out of the cervix, grasp them with a long pair of forceps (which doesn’t hurt).   Then I ask my patients to cough, which is distracting gently pull on the strings to remove the IUD in less than 10 seconds.
6. Sometimes but not always, a woman may experience a slight amount of cramping as the IUD comes through the cervix. This usually dissipates in 5-10 minutes. Most women will not have any cramping at all and can resume all of their normal activities including exercise within 30-60 minutes after removal.  
7. Do plan to bring a pad with you in case there’s spotting. Some women may experience a little spotting for 1-3 days, however, most don’t.
8. Of course, anytime a woman has any other issues from any procedure, such as pelvic pain, continued bleeding or spotting, she should contact her health care provider, as she will need to be evaluated.
   

Right now the FDA is considering extending the length of contraception for Mirena from 5 years of active contraception to 7 years, as some research shows that it’s still effective then.  We, as health care providers have to go with the package insert and say to our patients that it’s best to have it removed in the same month that they had it inserted 5 years later. So mark your calendars.