What to Do if You Can't Feel Your IUD Strings

It’s common for them to move, but missing strings could be a problem

If you can’t feel your IUD strings, it’s possible that they’ve moved. When this happens, don't panic—the IUD is still secure and working as an effective form of birth control. 

There are a few reasons why you might not be able to feel your IUD strings when you check for them. While it's possible that the IUD has fallen out of your uterus (expulsion), the strings may have simply curled up against your cervix. Curled strings may fall back in place during your next period.

This article explains how and why your IUD strings may feel like they're missing. It discusses what to do if you think there's a problem with your IUD and how healthcare providers treat this issue.

Why can't I feel my IUD strings?

Verywell / Emily Roberts

Why You Need the IUD Strings

An intrauterine device (IUD) such as Mirena or ParaGard has two strings that hang from your cervix into your vaginal canal. The IUD strings allow your healthcare provider to pull the IUD out of your uterus when the time comes. IUD strings also allow you to check that your IUD is in place.

How to Check IUD Strings

If you put a clean finger into your vaginal canal, you should be able to feel the tip of both IUD strings hanging from your cervix.

When you first have your IUD inserted, you should be checking for your IUD strings every few days. Keep doing so for the first few weeks. You should also check for your IUD strings between periods.

In some cases, you may be certain that your IUD has come out. This will typically happen during the first few months of IUD use. Your IUD is most likely to slip out of place during your period. Check your pads and tampons each time you remove them to be sure that your IUD has not been expelled.

What Strings Feel Like

Each IUD string is typically 1 to 2 inches long. IUD strings are made of very thin plastic that softens and may curl over time.

If you feel your IUD strings poking you, the strings may be too long or the IUD may have moved in your uterus. Either way, if you feel your IUD strings poking you, you should schedule an appointment with your healthcare provider.

What do IUD strings feel like for your partner?

Your partner may be able to feel your IUD strings during intercourse. The IUD strings should not hurt them, however. If they bother you or your partner, let your healthcare provider know. The provider may be able to cut the IUD strings shorter so that your partner is less likely to feel them.

Common Reasons for Missing Strings

There are two very common reasons for missing IUD strings. One is that the IUD has come out of the uterus. The other is that perforation has occurred during IUD insertion.

Should I use backup birth control?

If you experience expulsion or perforation, you will need to use a backup birth control method to protect against pregnancy. This is because the IUD will not protect you against pregnancy when it's out of place. If your strings are missing, you should use backup birth control until you can confirm that your IUD is still in place.

A few other reasons for missing strings include:

  • Coiled strings: There's also a chance that the IUD is still in the correct position but the IUD strings have coiled and bent back into the endocervical canal. This is the passage between your cervix and your uterus. It's also possible that the strings could have broken off.
  • Short strings: It is possible that your strings were cut too short for you to feel them. In this case, your IUD would still be in place and working to prevent pregnancy.
  • Rotated IUD: The IUD can rotate either during or after insertion. The turning of the device could cause the strings to retract higher in your body. If this is the case, the good news is that the IUD is still working and in place. The issue is just with the strings.
  • Uterine swelling: Uterine swelling or enlargement due to fibroids or pregnancy can cause the IUD strings to be pulled back up into the uterine cavity. When this happens, the IUD is still in the uterus. Further investigation would be needed, however. Most healthcare providers will use ultrasound imaging to try to find the IUD and/or rule out pregnancy.

If your IUD strings are missing but your IUD is still in place, healthcare providers recommend an ultrasound once a year for the first few years. This is because of the higher risk that it may be expelled during that time. The images will help to make sure your IUD is still in place.

IUD Falls Out

One of the reasons why you may not be able to feel your IUD strings is because your IUD has fallen out. This is called expulsion.

Signs 

If your IUD has been expelled, you may not have any symptoms. Sometimes, expulsion can cause symptoms like:

  • Heavy bleeding
  • Cramping
  • Unusual vaginal discharge

Because it's possible to have no symptoms following IUD expulsion, it's important for you to know how to check your IUD strings. It may be the only way to tell for sure if your IUD has come loose or has moved out of place.

Risk Factors

IUD expulsion, in which the IUD comes out of the uterus, is not common. A study of 10,747 people in India found that 4% had IUD complications. Three-fourths of this group reported the problem as either expulsion or missing IUD strings.

Some of the risk factors for IUD expulsion may include:

Your risk of IUD expulsion is higher if you are under age 20, or if you've had it happen before. Often, there are no symptoms and the missing IUD strings are the only sign of a problem.

What to Do

If you can't see or feel the IUD or the IUD strings, you should see your healthcare provider to make sure that your IUD has not been expelled. Use a backup birth control method until your healthcare provider can confirm that the IUD is still in place.

Perforation

This means that the IUD has been pushed through the uterus wall. This can be a serious complication. Generally, though, it is quickly noted and it can be corrected right away.

Signs 

Perforation is uncommon, occurring in fewer than 1 out of every 1,000 insertions. Besides being unable to feel the strings, you may also experience symptoms such as:

  • Severe pain after insertion
  • Pain or heavy bleeding that continues for weeks after insertion
  • Pain during intercourse
  • A sudden change in menstrual bleeding

However, in some people, perforation does not cause any symptoms.

Risk Factors

Although perforation isn't common, there are some things that can put you at higher risk for this complication, including:

  • It is less than 36 weeks since you gave birth.
  • You are breastfeeding.

What to Do

If you think you're experiencing perforation, see your healthcare provider right away.

When to See a Healthcare Provider

If you cannot see or feel your IUD strings, the next step is to call your healthcare provider. They will need to perform an exam to find out why your IUD strings can't be felt or are missing.

If it's confirmed that the IUD is in place and you are not pregnant, then there are several ways to try to recover your IUD strings. Healthcare providers use a special brush called a cytobrush. It looks like a long mascara brush and is used to try to coax out the IUD strings. This usually works.

If the cytobrush doesn't work, there are other options. Your healthcare provider may use various tools to dilate (open) the cervix and measure your uterus. They'll then get a precise view of the endocervical canal. This makes it possible to see if the IUD may be in the process of expulsion.

When an IUD is in the process of expulsion, the strings tend to become more visible. IUD strings can also become twisted and out of view, though. If the IUD has been partially expelled into the cervix, the healthcare provider will typically remove it. They can replace it with a new IUD at the same time.

If all of these efforts fail to locate the IUD, a healthcare provider may order X-rays of your abdomen and pelvis. If your IUD does not show up on the X-ray film, expulsion can be confirmed. At this time, you can also get a new IUD inserted if you wish.

An X-ray may reveal that perforation has happened. This would need to be corrected as soon as possible before an infection starts or any damage occurs to nearby areas of the body.

Summary

An IUD has strings on it so that you can tell that it's still in place in your uterus. If you can't locate your IUD strings, it may be because your IUD has been expelled and is no longer working to provide contraception.

There are other reasons why IUD strings might "go missing." They may be twisted and bent where you can't feel them, or the IUD itself may be rotated within the uterus.

If the IUD is missing, your healthcare provider can place a new one. If the IUD is still there but is not inserted properly, they can remove it and replace it. In most cases, an IUD problem is not serious, but you'll need to use backup birth control until your healthcare provider confirms that your IUD is safely in place.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Jatlaoui TC, Riley HEM, Curtis KM. The safety of intrauterine devices among young women: a systematic review. Contraception. 2017;95(1):17-39. doi:10.1016/j.contraception.2016.10.006

  2. Nowitzki KM, Hoimes ML, Chen B, Zheng LZ, Kim YH. Ultrasonography of intrauterine devices. Ultrasonography. 2015;34(3):183-94. doi:10.14366/usg.15010

  3. Gehani M, Pal M, Arya A, et al. Potential for improving intrauterine device (IUD) service delivery quality: results from a secondary data analysisGates Open Res. 2020;3:1473. doi: 10.12688/gatesopenres.12997.3

  4. Melo J, Tschann M, Soon R, Kuwahara M, Kaneshiro B. Women's willingness and ability to feel the strings of their intrauterine device. Int J Gynaecol Obstet. 2017;137(3):309-313. doi:10.1002/ijgo.12130

  5. Gov.uk. Intrauterine contraception: uterine perforation—updated information on risk factors.

  6. Gündüz R, Ağaçayak E, Dönmez DA, Findik FM, Evsen MS, Gül T. Evaluation of patients with uterine perforation after intrauterine device placement and determination of risk factors: A retrospective case-control study. East J Med. 2022;27(2):264-71. doi:10.5505/ejm.2022.88155

  7. Kathpalia SK, Singh MK, Grewal DS. Nonpalpable intrauterine device threads: Is it a cause for worry? Med J Armed Forces India. 2017;73(1):85-87. doi:10.1016/j.mjafi.2015.05.004

  8. Devassy R, Gopalakrishnan S, Torres-de la Roche LA, Verhoeven H, De Wilde MS, De Wilde RL. The missing intrauterine device. Int J Reprod Contracept Obstet Gynecol. 2016;5(10):3588. doi:10.18203/2320-1770.ijrcog20163449

Additional Reading

By Dawn Stacey, PhD, LMHC
Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience.