IUD expulsion can occur in 2-10% of women in the first year after insertion. Expulsion can be more likely for women who:

• Haven’t been pregnant
• Are younger than 20 years
• Have a history of very heavy or very painful periods (though be mindful that these are reasons doctors recommend the hormonal IUD in the first place…)
• Had the IUD put in right after giving birth or having a 2nd trimester abortion.

A partial expulsion may mean that the IUD was not quite in the right position: it may have been too low in the uterus and just worked its way out. This could be something that happened around the time of insertion, or may be related to uterine characteristics, such as size, angle, or presence of conditions like fibroids that can cause irregular shape. For women who have an IUD expulsion, the chance of expelling a 2nd IUD may be highert—in the 20% range (up to 30% in some studies).

If you want a second IUD after the first one came out, consider asking your doctor about inserting the 2nd IUD while using an ultrasound machine to make sure the IUD is inserted all the way to the fundus.

As far as tampons and IUDS go, Planned Parenthood puts it like this: “Tampons and IUDs are kind of like next-door neighbors. They’re close but they live in different parts of the reproductive system. An IUD and a tampon are separated by the cervix, and don’t interfere with each other’s business.”

You should be fine as long as you are careful not to pull on the IUD strings, which you shouldn’t need to worry about too much since the string of a tampon are outside of your vagina and the strings of your IUD should be up near your cervix. (If you find that your IUD strings are anywhere near your tampon strings, you should go see your health care provider because your IUD might be expelled.)

Spotting, which can happen with a bunch of different methods, doesn’t make you lose that much blood, even though it might seem like it. We have a Provider Perspective article about it if you want to learn more.

The strings of the IUD usually get softer over time, but if they’re really a problem for your partner, talk to your health care provider about adjusting them or cutting them shorter.

This one is easy. If you’re ready to get pregnant, just have your IUD removed. The hormones in your body should go back to normal quickly and you can start trying right away.

You may be able to find some stories online about people removing their own IUD, but we wouldn’t recommend trying it. There just isn’t enough research at this point to know if it’s safe.

Plus, if you’re not happy with your IUD, going to your health care provider to get it removed will give you a chance to ask about other options for birth control. Or if you’re ready to get pregnant, you can talk with your provider about things you should do to prepare for a healthy pregnancy.

The IUD shouldn’t hurt your partner. You may have heard that the IUD strings can bother men while having sex, but most partners can’t even feel the strings. If your partner can feel the strings, and that bothers him, your healthcare provider might be able to trim them. Plus, they usually soften over time.

If you feel like your birth control is changing your behavior, it’s time to talk to your health care provider. Everybody responds to birth control differently, and your provider can help you decide whether it’s time to try something else. It might be a matter of switching hormonal methods or deciding whether to avoid hormonal birth control altogether, or you may choose to wait it out since some negative side effects go away with time. The bottom line: If your current method is making you feel blah, don’t settle. There are a lot of methods to choose from and sometimes it can take a few tries to get it right.

If this is the case, you’re probably using a copper IUD (ParaGard). Sometimes things get better if you just give it a couple months. You can also take ibuprofen the first few days of your period.

As long as you’re careful to avoid suction or pulling your IUD strings when you remove your menstrual cup, it’s fine to use a cup and an IUD together. A recent study found that the “use of tampons or menstrual cups does not increase the risk of early expulsion of an IUD.” The packaging information for IUDs can be inconsistent, but women “can use whatever their usual menstrual product is and not increase their risk of expelling the IUD.”

Menstrual cup brands are in agreement about this. DivaCup, MoonCup/Keeper, MeLuna, Lunette, and SoftCup say that because of the physical placement of your cup, you should be fine combining one with an IUD. If you can, try to double check with your health care provider first to be on the extra-safe side.

Unless you’re on a desert island or stranded in some kind of post-apocalyptic-last-person-on-earth scenario, we highly recommend having a professional do it. There are a lot of reasons why it’s better (and safer) to have your health care provider remove your IUD for you.

IUD insertion pain can vary from person to person, but unfortunately there isn’t a great drug to take to make insertion less painful.

You can try taking ibuprofen beforehand, and make sure you get the IUD inserted when your cervix is open, such as when you’re on your period or ovulating. Even if there is some pain, it might be worth it for years of worry-free boot knocking.