IUD Removal: Procedure, What to Expect, and Aftercare

Intrauterine device (IUD) removal is a quick, low‑risk office procedure. Knowing what happens reduces anxiety and helps you plan.

Before the Appointment

• Eat a light meal; stay hydrated.
• Avoid NSAIDs (ibuprofen, aspirin) 24 hours prior if you bruise easily—though many clinicians now say they’re fine for cramp prophylaxis.
• Wear comfortable clothing; bring a pad for possible spotting.
• Consider taking 600 mg ibuprofen 30–60 minutes before (if no contraindications) to reduce cramping.

Procedure (Typically 2–5 Minutes)

1. Speculum insertion; cervix visualized.
2. Grasp IUD strings with ring forceps.
3. Steady, gentle traction—device slides through cervical canal.
4. If strings not visible: ultrasound‑guided removal with alligator forceps or hysteroscopic retrieval (rare).

Sensations

• Brief cramping (like a strong menstrual cramp) as the IUD passes the internal os.
• Possible vasovagal response (lightheadedness, nausea)—inform clinician if you feel faint.

Immediate Aftercare

• Rest a few minutes in the office; light bleeding/spotting is normal for 1–3 days.
• Use pads (not tampons/cup) for 24–48 hours to reduce infection risk.
• Resume normal activities same day; avoid vaginal insertion for 24 hours.
• OTC analgesics as needed.

Rare Complications

• Infection (fever, foul discharge, severe pain).
• Uterine perforation (sharp pain, hemorrhage—extremely rare on removal).
• Incomplete removal (fragment retained—requires hysteroscopy).

Fertility Return

Ovulation can resume immediately. Start a new contraceptive method before removal if you wish to avoid pregnancy.

When to Call Your Clinician

Heavy bleeding (soaking >1 pad/hour), fever >100.4°F, worsening pelvic pain, or malodorous discharge.