The disappearance of the thread of the IUD should not generate anxiety, especially since it is sometimes invisible from the pose. However, any concern in the patient justifies consulting her gynecologist, or even her doctor or her midwife. In the event of acute pain following the recent installation of an IUD, a rapid consultation is essential.
Is it possible to lose the thread of your IUD?
The IUD or intrauterine device (IUD) is a contraceptive method that comes in the form of a T. The IUD is hormonal or copper and measures on average 3.5 cm. The IUD is fitted with a nylon thread : “after the IUD is placed in the uterine cavity, we cut the wire more or less long in order to adapt its length in the vaginaexplains Doctor Elizabeth Paganelli, gynecologist and general secretary of SYNGOF. The size of the length is determined with the patient and the midwife or gynecologist before cutting the thread of the IUD. Sometimes, we cut it very short, and then it becomes invisible. It is always advisable to have a good discussion with the professional beforehand. Some patients want it short so it won’t be awkward or for fear that the thread will get caught. We can offer to cut the thread short if the woman puts on tampons or uses a menstrual cup. Once the IUD is in place, we see the thread in the endocervix, spreading the banksbut already at this moment, the patient does not feel the thread.”
The IUD does not increase the risk of sexually transmitted infections (STIs).
Why does the IUD thread disappear?
The thread of the IUD disappears when it is cut very short or when the woman loses her IUD. “In case of unwanted pregnancythe uterus enlarges, the IUD straightens, and sometimes it goes up further into the uterine cavity, explains Doctor Paganelli. This is also a possibility in case offibromatous uterus. The thread can simply disappear because the IUD is lost. “It leaves with the rules, in case of very abundant flow, sometimes with the presence of clots, because the pressure is greater. Inserting an IUD postpartum increases the risk of losing it. Postpartum, there is also a greater risk that the IUD will perforate the uterine wall and end up in the peritoneum. Moreover, during the consultation after the insertion of the IUD, theProper placement of the IUD is easy to check with the help of an ultrasound. Nevertheless, “verification ultrasound is not part of the recommendations, so it is not systematic among all professionals”.
A misplaced IUD can cause:
- Of the pains in the lower abdomen;
- Feelings of embarrassed ;
- Of the contractions uterine.
“The uterus has a larger cavity above than below. The patient feels contractions when it is positioned in the upper part. The patient is embarrassed, she does not feel well. If the IUD is in the lower part of the uterus, the patient has a stomach ache, feels discomfort when sitting down, discomfort when having a bowel movement or during sexual intercourse. She senses something wrong”, completes the gynecologist. And to add that “the hormonal IUD, even if placed incorrectly, continues to function and act as a contraceptive, as it delivers hormones. It therefore protects against the risk of pregnancy. A displaced copper IUD is a little less effective, but still more effective than nothing.”
What risks?
If the IUD descends into the uterine cavity and then falls out, this leads to risk of unwanted pregnancy, which is the main problem. The diagnosis of pregnancy can then be delayed, especially in the case of a hormonal IUD which often causes an absence of menstruation. During insertion, an IUD may have crossed the uterine muscle and it may cause risk of uterine perforation. It is a rare complication, but it does exist. However, the risk is more frequent when the IUD is placed very soon after childbirth. “We do not have statistics concerning this complication, because it is not subject to compulsory declaration.“, specifies the general secretary of SYNGOF. And to recall that “Ia uterine perforation is not life-threatening urgently, but the patient will have to go through the block and undergo a laparoscopy to remove the IUD.” Contrary to popular belief, thehe IUD does not increase the risk of sexually transmitted infections (STIs).
What to do if the thread of the IUD has disappeared?
“The patient does not systematically see the fallen device (expulsion of the IUD). If the IUD is in place in the uterus, but we, as healthcare professionals, do not see the thread, we always manage to remove it. If the patient is in pain or worried, she must consult in order to be reassured.” It is also good to know that the risks of losing the IUD and the risks of complications are greater shortly after the insertion of the IUD. An IUD that has been well supported for several years has very little risk of moving or falling. “A properly fitted copper IUD can stay in place for 10 or 12 years”, says Doctor Paganelli. If the patient can no longer see the thread, there is no need to go to the emergency room, nor to worry too much.
The IUD is practical, but it deserves monitoring
She can make an appointment with her gynecologist, the midwife, the latter being able to carry out the pelvic ultrasound or with her attending physician, who will refer her to a healthcare professional who will perform an ultrasound to check the position of the IUD. In the event of acute pain, you must contact the healthcare professional who inserted the IUD urgently. If the patient cannot see him (or his associates) in emergency, she will go to gynecological emergencies by default. “As a reminder, midwives have the skills required to insert and remove IUDs. Some of them even have ultrasound machines, so they can quickly check the position of the IUD.” Also, the control visit should not be neglected. “Many women do not come to their appointments following the insertion of an IUD, because they feel good. Gold, this visit is very important, even crucial, because it can avoid recourse to medical care and consultations in emergency hospital services. The IUD is practical, but it deserves monitoring. The weeks following the installation, the consultation is essential to take stock of the feelings, it is not a waste of time. The IUD is better supported when the patient is reassured, in particular thanks to a time of exchange and listening between her and the health professional.
Thank you to Doctor Elizabeth Paganelli, gynecologist and general secretary of SYNGOF (Union of Gynecologists and Obstetricians of France).
- Contraception, The IUD, National College of French Gynecologists and Obstetricians (CNGOF)