How Does IUD Removal Work? OB-GYNs Share What You Can Expect

If you have an intrauterine device and are considering starting a family (or just want to try a new contraception), you’ll need to have it removed. For most women, removing it will be similar to the insertion process — which, if we’re going to be honest, probably hurt like a mofo. So, it’s normal to have a lot of questions about it, whether you’re concerned it will be painful or how it will affect your fertility and hormones.

But don’t stress too much: Having your intrauterine device, or IUD, taken out is typically a quick procedure you can have done at your doctor’s office or local health clinic. To help ease your mind, read on for insight from OB-GYNs on what to expect from your IUD removal.

When should you have your IUD removed?

If at any point you want your IUD removed, that’s your prerogative! Bring it up with your doctor so you can schedule a time for the removal. However, you may also need to get your IUD removed if it has expired. While it’s always best to ask your doctor how long yours is supposed to last, the following replacement guidelines offer a good frame of reference:

  • Kyleena = 5 years
  • Liletta = 8 years
  • Mirena = 8 years
  • Paragard = 12 years
  • Skyla = 3 years

What happens during the IUD removal?

If you’re nervous about your IUD removal, there’s some good news. According to Dr. Alex Robles, a board-certified OB-GYN, the removal process is pretty straightforward, “not painful,” and only takes a few minutes.

The removal process involves a speculum exam (similar to a Pap smear) “to visualize the strings of the IUD,” Robles tells Scary Mommy. By design, every IUD has very long strings attached to the bottom of it. “When an IUD is placed, we purposefully leave the strings long and visible for two reasons: one, so that we can confirm that the IUD is still inside at some point in the future, and two, to remove the IUD.” After visualizing the strings, the doctor will use a small clamp to grasp the strings and gently pull the IUD out.

Robles adds that the process is the same for a copper (non-hormonal) IUD and a progesterone IUD.

What are the side effects?

Dr. Greg Marchand, a board-certified OB-GYN, says that post-removal, you can expect some bleeding and cramping but “nowhere near the amount of pain that’s associated with insertion. Also, in the weeks and months following removal, you can expect your periods to return to what they were prior to the IUD.”

Marchand says there is no healing necessary, but removing the IUD may cause the uterus to contract or spasm for several minutes. He advises taking ibuprofen before or after the removal, although it’s not mandatory.

In the weeks and months following removal, Marchand warns you can expect your periods to return to what they were prior to the IUD. “For many women, IUDs (particularly hormonal IUDS) mask bad periods, so many women, unfortunately, have an undesirable bleeding pattern following removal.”

How fertile are you after an IUD removal?

Robles says fertility may return immediately for some women after an IUD removal, even if their period doesn’t return right away.

“This is especially true if you had a copper (non-hormonal) IUD, as you were still ovulating throughout the time that you had it placed,” he explains. “If you had a progesterone IUD, you may or may not have been ovulating, and it can take several months for your periods to normalize.”

And if you’re wondering, there isn’t a difference in fertility rates after removal between both of the IUDs, according to Robles.

That being said, March points out that IUDs often stay in place for up to seven to eight years, so it is very common for a woman’s fertility to decrease or even be completely gone as the years pass, depending on your age when you have the device placed and removed. But this is due to your age and fertility and not the IUD.

As for how you can track your fertility post-removal, Robles says the only sign that a woman will be able to see regarding fertility is the resumption of her regular menstrual cycle. “With that said, it is possible to ovulate without your menses, so a woman can also routinely check ovulation predictor kits to see if she is ovulating.”

Another thing to remember: There is no waiting period to become pregnant, “and you actually can become pregnant from sperm you received up to three days before the IUD removal even happened,” Marchand says. So, yeah… keep that in mind.

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