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Health & Fit What to Expect After IUD Removal: Ob-Gyn Experts Explain

16:55  22 july  2020
16:55  22 july  2020 Source:   self.com

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  What to Expect After IUD Removal: Ob-Gyn Experts Explain © SELF

Whether you have an IUD removal on the books or you're just wondering what the procedure is like, you've come to the right place. IUDs, also known as intrauterine devices, are little T-shaped instruments that reside snugly inside the uterus and ward off pregnancy. Even if you’ve had years of contraceptive bliss with your IUD, there will inevitably come a time where you begin to think about parting ways with your intrauterine device, whether you're ready to start trying to conceive, it’s reached its effectiveness time limit, or you’re simply ready to explore another method. If you've been through the insertion process, you might think about your IUD removal with at least a little trepidation. Good news: Chances are your IUD removal will be less painful than the insertion (and quicker, too). Here, ob-gyns explain exactly what to expect during and after IUD removal so you can be as prepared as possible.

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First, what exactly is an IUD?

As we mentioned, an IUD is a contraceptive device that actually sits in the uterus and prevents pregnancy. There are two types of IUDs: hormonal IUDs and non-hormonal copper IUDs. The hormonal kinds release levonorgestrel, a synthetic form of the hormone progestin, to prevent ovulation, thicken cervical mucus, and thin the lining of the uterus, according to the U.S. National Library of Medicine. The non-hormonal IUD releases copper ions, which are toxic to sperm, the Mayo Clinic explains.

IUDs sound like some impressive sci-fi invention, but they're real, and they're giving many people with vaginas excellent control over their reproductive futures. IUDs are known as a “set it and forget it” birth control method because they are effective for years after insertion with basically zero upkeep on your part. (How many years depends on the specific type, which we’ll address in a moment.)

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When do I need to get my IUD removed?

The timeline for IUD removal varies based on the specific type of IUD and how long it works.

Here’s how long hormonal IUD options are recommended for use:

  • Mirena: recommended for up to five years

  • Kyleena: recommended for up to five years

  • Liletta: recommended for up to six years

  • Skyla: recommended for up to three years

As for the copper Paragard, which doesn't use hormones? That superstar is recommended for up to 10 years of use, the Mayo Clinic says. Remember: You can always get your IUD removed earlier than any of these benchmarks if you want to get pregnant or if you've decided another birth control option makes more sense for you.

What actually happens during IUD removal?

You know those strings hanging out of the bottom of your IUD? This is their time to shine. "The vast majority of the time, [IUD removal] involves doing a simple exam much like a Pap smear," board-certified ob-gyn Antonio Pizarro, M.D., tells SELF. "If the strings are visible, the doctor grasps them using an instrument called ring forceps and gently pulls the IUD out." When they tug on the strings, the arms of the IUD will fold so that it comes out safely, according to the Mayo Clinic.

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"Usually patients get really worked up, then when it's done, they say, 'Oh, that's it?'" Jacques Moritz, M.D., an ob-gyn at Weill Cornell Medicine and New York-Presbyterian Hospital, tells SELF. The general ease of removal comes down to a few major things, he explains: Your doctor doesn’t need to push past your cervix to make sure the IUD sits in the appropriate place, the IUD's wings don't have to open up in your uterus (ditto), and, as we’ve already mentioned, the IUD's arms just fold in on themselves when it's being removed, so it's as small as possible.

Is IUD removal painful?

"Anyone who has an IUD basically paid the price when getting it," Dr. Moritz says, explaining that insertion tends to be much more uncomfortable than removal. Keep in mind that even when rating IUD insertion as terrible, these devices provide such stellar protection against pregnancy that most people consider the temporary pain well worth the reward.

"Everybody gets nervous about [removal], but it should almost not be felt," Dr. Moritz says. Can't you practically feel your uterus relaxing at this very welcome news? Even better, depending on your insurance, the cost of the removal may be covered.

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How long does IUD removal typically take?

Just as IUD removal is often less painful than IUD insertion, it turns out that IUD removal tends to be much quicker than IUD insertion as well, the American College of Obstetricians and Gynecologists (ACOG) explains. Under normal circumstances, the removal shouldn’t take more than a few minutes "Just one deep breath, and it’s done," Dr. Moritz says. (There are rare cases when it might take a bit longer, but we’ll get to that in a second.)

Are there any IUD removal complications to know?

As we’ve mentioned, the whole process usually takes a few minutes, but in the rare case that the doctor can't find the strings, removal becomes a bit more involved. The IUD strings can shift a bit, sometimes curling up around the cervix so they're harder to access, or maybe they were cut too short in the first place. In those instances, doctors can try to "tease" them out using some instruments, and it won't exactly feel pleasant, Dr. Moritz says. This can definitely be uncomfortable, he says. He gives himself a cutoff of 10-15 minutes to try teasing the IUD out. If that doesn't work, other measures will.

"Rarely do IUDs become dislodged or the strings get lost," Dr. Pizarro says. But on the off chance that something like that happens, doctors may use an ultrasound or hysteroscope (a thin lit tube that allows a doctor to see inside the uterus) to locate the IUD so they can remove it, potentially with anesthesia depending on the situation, the ACOG says. "Even then, it's limited invasiveness," Dr. Pizarro says.

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What kind of IUD removal side effects should I be prepared for?

You might feel some cramping as the doctor pulls out the IUD (again, it shouldn't feel anything like the cramping some people experience during insertion), or you might not even realize it's happened, Dr. Pizarro says. Beyond that, you may experience some residual cramping after an IUD removal.

You may also be wondering, Will I experience bleeding after my IUD removal? Yes, you may experience some spotting after an IUD removal, but as long as it isn't heavy and goes away in a few hours or, at worst, a couple of days, that's totally normal, the Mayo Clinic explains. As a general rule, the ACOG says that heavy bleeding involves soaking through one or more tampon or pad every hour for several hours, any bleeding that requires you to wear more than one pad at a time, or bleeding that includes clots that are as big as a quarter or larger. If your bleeding meets these criteria, it’s best to touch base with your provider

One thing to really think about is that your period may change after IUD removal depending on what kind of IUD you had and how the device influenced your cycle over time. Hormonal and non-hormonal IUDs can change periods in different ways. You might enjoy lighter, less painful periods on a hormonal IUD like Mirena—or they may stop completely. So, when you get a hormonal IUD removed, your period will probably revert to what it was like without hormones, Dr. Moritz says.

As for the copper IUD, it's all about how your body adjusted to it over time. Copper IUDs can make periods heavier and crampier at first, but for some people, that abates, while others deal with more intense periods the entire time they have the IUD, the Mayo Clinic says. After getting a copper IUD removed, your period might become lighter and less annoying or not change much at all, the experts explain.

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Can I just remove my IUD myself?

Pulling a few strings sounds simple enough, but pulling out an IUD is not as easy as pulling out a tampon. Sometimes some elbow grease is necessary when removing an IUD, and without medical training, you could hurt yourself. You might end up accidentally cutting yourself, for example. The bottom line? Leave IUD removal to the pros.

How long does it take to get pregnant after IUD removal?

"Fertility is possible immediately," Dr. Pizarro says. If you're not ready to have kids now or ever and liked your IUD experience, it might make sense for you to get another IUD in the same visit (you're already there, after all).

If you decide not to get a new IUD for whatever reason and you're not interested in getting pregnant, be sure to talk to your ob-gyn so you can find another reliable form of contraception.

Related:

  • The Truth About Getting Pregnant When You Have an IUD

  • When Is It OK to Get Your IUD Removed?

  • 13 Things You Absolutely Should Know Before Getting the Copper IUD

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