If you already have an intrauterine device (IUD) to keep you from getting pregnant or are curious about getting one, you might wonder what it’s like to get it out and whether it’s possible to do it yourself. First, keep in mind that IUDs can last for 3 to 10 years, depending on which type you have. So, unless you decide you want to get pregnant, there’s a good chance you won’t need to have it removed for quite some time. When it’s time to remove it, it will more than likely be a quick and easy process, no matter who does it.
In most cases, your doctor will remove it when you’re ready. If you want it out early on because of side effects you’re having, your doctor might suggest you give it a little more time. That’s because those early symptoms, like pain or cramping, often go away.
But, says Diane Greene Foster, PhD, a professor of obstetrics and gynecology at the University of California, San Francisco, if you’re ready to have it out for any reason, it’s perfectly OK to try to remove it on your own.
“If you can grab the string, you can remove it yourself,” she says. “But, if you don’t get traction, you can’t do it. If you can’t feel the string, your chance of removing it yourself is zero.”
How to Remove an IUD
The IUD is a small, T-shaped device made of plastic or copper. There’s a string at the end of the T to help with removal, much like the string on a tampon. A doctor has to put it in. They’ll guide it carefully through your vagina and cervix and then into your uterus. So, putting an IUD in place takes some know-how. It isn’t something you could do yourself.
Most of the time, taking an IUD back out is a whole lot simpler. If your doctor does it, they’ll have you lie on your back with your legs apart, just as you’d do for a regular exam. They’ll grasp the string with an instrument and gently pull out the IUD. As they pull, the arms of the T will fold upward, making it as small as possible on the way out. If you want to try doing it yourself, you’ll do pretty much the same thing.
“When a woman pulls on the string, it’s exactly what a clinician would do,” Foster says.
The only difference, she says, is that you’ll have to rely on your fingers instead of a special tool. You won’t be able to see what you’re doing either. But, Foster says, there’s really no harm in a DIY approach to IUD removal if it’s something you’re willing to try.
Self-Removal Success and Failure
While it isn’t risky to try to take it out, there’s also a good chance you won’t succeed. A study Foster led on women’s thoughts about and attempts to remove their own IUD found that more than half of 326 women in the study were willing to try to take out their IUD themselves. But, of those who tried, only one in five succeeded.
For those who managed to get it out, the whole process took less than 4 minutes. The main difference between those who got it out and those who didn’t was the length of the IUD string. Strings that were at least 7 centimeters long were easier for women to feel and grab onto. Women who tried taking it out while propping one foot on a stool also had more trouble getting their IUDs out.
Foster says those who want to try removing an IUD can experiment with different positions. In her study, it was better to squat or lie on your back with legs apart, just as you’d do at the doctor’s office. She says it helps to relax and take your time. Consider wearing a glove to get a better hold on the string. The study showed no difference in pain between those who got their own IUD out and those who didn’t.
For those who couldn’t remove it, she says, “it’s not that it was painful. They just weren’t successful because they couldn’t get the string.”
Consider Your Options
It’s not uncommon for doctor’s to discourage IUD removal and especially self-removal. But that’s often because taking it out yourself means you’re missing a chance to talk with your doctor about your plans for either another birth control method or trying to get pregnant. Foster says there’s really no added risk in trying to remove it yourself. If your IUD isn’t going to come out easily, you simply won’t be able to remove it.
“There is a risk of IUD removal, but it’s the same whether a clinician removes it or a woman removes it,” Foster says, noting that the main risk is a drop in blood pressure in response to having your cervix touched.
“The same can happen during intercourse or a pelvic exam,” Foster says. “It’s rare and doesn’t change whether the woman is doing it or a clinician. And women who experience this may know they are at risk because they have fainted during pap smears, for example.”
Studies show that women sometimes want to do it themselves because of concerns about the cost of seeing a doctor. Sometimes they may find they want the IUD out and can’t get an appointment fast enough. Ultimately, Foster wants women to know it should be a matter of personal preference. If cost is an issue, you may want to try doing it yourself. But, if you aren’t comfortable trying to remove an IUD on your own -- and many women aren’t -- then have your doctor do it for you.
“IUDs are really great birth control methods,” Foster says. “Why more people don’t use them could in part be out of concern that when they want to stop, it will be hard to get it out. So, having that control over discontinuation seems really important.”
One way to increase the odds you’ll have that option, she says, is to ask your doctor to keep the string long.
“You don’t need to explain why you want them long,” Foster says. "People want them long for a variety of reasons, and it should be your preference. Some think short strings are poky. Some want them short enough to disappear completely. It needs to be patient preference on string length, and it should be on the clinician to ask if you want the string long or short.”
