My IUD was expelled. Should I try again?

IUD expulsion (when part or all of the IUD comes out after it’s placed in the uterus) can occur in 2-10% of people in the first year after insertion. Expulsion can be more likely for people who:

1. Haven’t been pregnant
2. Are younger than 20 years
3. Have a history of very heavy or very painful periods (though be mindful that these are reasons the hormonal IUD is recommended in the first place…)
4. Had the IUD put in right after giving birth or having an abortion after 14 weeks.

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 the size, angle, or conditions like fibroids that can cause the uterus to have an irregular shape. For people who have an IUD expulsion, the chance of expelling a second IUD may be higher—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 health care provider about inserting the second IUD while using an ultrasound machine to make sure the IUD is inserted all the way to the top of the uterus where it belongs.

Still not working?

If you like the ease of having birth control that’s really effective at preventing pregnancy that you don’t have to think about for years, but are having problems with expulsion, you could try switching to the implant—it lasts for up to five years and once it’s in, there is no follow up needed as long as you are happy with it.