What to expect IUD removal

[fernweh]

I am getting my IUD removed and a new one placed. I got my first one at me PCP office but they don’t do removals so they referred me to an obgyn.
Prior to this I assumed the removal would be similar to the placement but I got nervous when my doctor office said they don’t do them.

What should I expect? Do I need to do anything in advance? When I got my original placed my doctor prescribed misoprostol- should I be asking for that to be prescribed again or is it not helpful (Google tells me there is no evidence that it helps and the risk may outweigh benefits but I have no basis for comparison)?

[atarianna]

This seems like an appropriate place to say: evidently there is a new semi-permanent BC for men that places a block in the vas deferens that pain-wise is almost identical to IUD placement/removal yet men are put under local or even general anesthesia for it. There is a ton of uproar in the reproductive health space about it because women have been told the iud placement and removal did not necessitate pain relief for years and years. Not to mention other gynecological procedures that are painful AF.

So another way we try to placate the men around us while we suffer in silence.

So my answer is: anything that makes the procedure easier and less painful should be done. Something to soften the cervix, and pain relief.

[wanderingback]

If the strings are visible it takes 2 seconds to remove and you might feel it or you might not. I don’t say that to minimize discomfort, I offer multiple pain management options for IUD placement including lidocaine (and IV sedation at 1 clinic that has the capabilities), but removal really is straight forward.

If the strings are not visible then that is a different story and it can be more uncomfortable and I offer the same pain management techniques I do for IUD placement.

That is very odd that the pcp wouldn’t remove it, sorry you had to deal with that. There’s no evidence that miso helps with pain during insertion or removal.

[lilypad1126]

I had mine removed and replaced a few weeks ago. The removal was no big deal at all. Didn’t even really feel it. I did take 800mg of ibuprofen beforehand but that was more for the insertion part. My obgyn talked to me about all sorts of options for pain management based on insertion pain, which I imagine would have helped with any removal pain, but again, that part I barely noticed.

Anyway, yes, ask about your options! They should want to make this less painful and should be open to talking options.

[meanie]

I took some Tylenol before the appt, but otherwise no prep was needed. It's basically the same procedure but with the extra step of taking it out which felt similar to putting it in. They had me take a deep breath when removing/inserting.

It did hurt, but there was no lingering pain. I think I had some cramps after and I ended up spotting for a month or so after which was annoying. I was REALLY nervous before but the whole thing was over within minutes. 

ETA - I just remembered that my OBGYN commented that I have a sensitive cervix or something like that so that may have contributed to my experience with pain/bleeding too.

[bex1973]

I had mine swapped out last year and for me it was NBD. The removal felt pretty similar to insertion and I didn't have pain at all and honestly I'm a baby with a pretty low pain tolerance.

[circa1978]

I have learned over the years that IUD experiences are so different but for me, removal was painless and the reinsertion was fine, however I didn't know how painful it was supposed to be before I had my first and had no issues there either. I have come to the conclusion that I have a wide set vagina, a high pain tolerance and that my provider was very experienced/skilled.

[glw]

I've had 3 IUDs. I didn't feel the removal other than a tug. Re-insertion, though, I nearly passed out. Three insertion attempts later I had to be put under for a fourth try. I really wish we could just get some actual pain prevention.

[sandandsea]

I took ibuprofen before the insertion and it was a tight cramp and then fine. I had minimal bleeding and very mild cramping but was 100% normal within a couple of hours. For the removal and replacement it was a much more severe intense cramping immediately (whoa) and then more heavy but not crazy cramping for a couple of hours and then I was back to normal by nighttime.

[litasail]

www.washingtonpost.com/wellness/2024/08/13/iud-removal-pain/

[tommygirl03]

I am on my 3rd IUD. I am the 1% where the IUD has been embedded in my uterus (twice!!). Removal for me was not awesome - my Doctor was pulling the strings until they broke (with my permission - I have a decent pain threshold). That was rather uncomfortable, but certainly not the worst I’ve ever experienced.
Once the strings broke, it was determined that I’d need an outpatient procedure to remove the old one, and then they just did the reinsertion then. Easy peasy. Crampy for a day or so the 1sr time. Second time was more like period cramps, but still nothing terrible. I’ll take that for 7 years of no periods any day.
All that is not to scare you. It really wasn’t a big deal - more annoying than anything that I had to deal with having a procedure and the scheduling crap that comes with it, rather than just the doc appt. I am almost 49, and my OVFYN said she will do one more if I want. So that I do not need to deal with menopause period nonsense.

[wanderingback]

Jan 10, 2025 8:45:02 GMT -5 atarianna said:

This seems like an appropriate place to say: evidently there is a new semi-permanent BC for men that places a block in the vas deferens that pain-wise is almost identical to IUD placement/removal yet men are put under local or even general anesthesia for it. There is a ton of uproar in the reproductive health space about it because women have been told the iud placement and removal did not necessitate pain relief for years and years. Not to mention other gynecological procedures that are painful AF.

So another way we try to placate the men around us while we suffer in silence.

So my answer is: anything that makes the procedure easier and less painful should be done. Something to soften the cervix, and pain relief.

The medication to soften the cervix also causes cramping (can also cause nausea, vomiting and diarrhea). So the reason it’s generally not recommended for IUD removal is 1) evidence doesn’t show it helps reduce pain and 2) you’d just be inducing cramp from the medication which defeats the point if you’re trying to not have cramping with removal.

Like I said above if the strings are missing or it’s a difficult IUD removal that’s a different story!

[statgirl]

My first insertion was painful (I was doing labor breathing and had cramping for a week followed by weeks of bleeding). So, I was nervous for removal and replacement.

My strings were missing so after a look-see and blind trying, I had an ultrasound. I gave permission to try again and prepared for the worst. Nope—removal was a breeze. Insertion wasn’t as bad as the first (still did labor breathing but no major cramping).

I would do a third but I kept longer strings this time. I did go home and have ice cream. I think of the day of pain as an exchange for not having a period most months and a 15 minute one towards the end of the effective period. The first six weeks of my first IUD, though, I was regretting it as I bled heavily. However, once that stopped (after UTI treatment—my poor undercarriage), it has been smooth sailing.

[Doggy Mommy]

I think it's unusual that they sent you elsewhere for removal. I've had 3 removals. The first was uneventful and painless. Second was the same. Third was worst case scenario - they couldn't see the strings and couldn't find it. Did an ultrasound and still couldn't find it. Sent me for an MRI, and turns out I have a bunch of fibroids that pushed it to a difficult location (the biggest fibroid is 15cm). They put me under to remove it because it would have been really uncomfortable to be awake for that. Then I went to a specialist put the new IUD in, which will stay until I get a hysterectomy. If yours is in a normal location, it will be way easier than insertion.

[SusanBAnthony]

It hurt a fucking lot.

Get drugs.

ETA: actually I don't remember if removal hurt so it probably didn't. But insertion was extremely painful (when I hadn't just had a baby fly out of there).

[basilosaurus]

Removal was nothing, and I got the good drugs for insertion and it still hurt like a mofo (I'm a puss who's never been pregnant). My doc was at least 100 years old, too. But as pp noted, it wasn't embedded. I did not get another reinserted at the same time.

[onthemove]

First insertion was the standard awful pre-kid insertion. Had it for 5.. years. My GP also did not do removal so sent me to OBGYN. It took her 3 ish tries to get it out, was 1 try away from sending me to specialist, but got it. I don’t remember it being painful, just uncomfortable.

Then had DD, second insertion at 6wks PP was like a normal cramp, had for 2 years and removal was NBD. Then had DS. Third insertion at 8wks PP was nothing at all.

[puppylove64]

I took 2 ibuprofen and it was no big deal.