IUD Removal: What to Expect, Risks, and Recovery

Medically Reviewed by Dr. Oluwakemi Balogun (Kemi), MD — Medhaven Health

Last updated: August 2025

An intrauterine device (IUD) is one of the most effective forms of birth control, but eventually, there comes a time when it needs to be removed. Whether you are ready to try for pregnancy, switching to another form of contraception, or simply reaching the end of your IUD’s lifespan, understanding the process of IUD removal is important for your peace of mind. For most people, the procedure is straightforward, but in some cases, situations like embedded IUD removal or hysteroscopy IUD removal may be necessary. This guide explains everything you need to know—from what to expect during a routine removal to what happens if complications arise.

How Is an IUD Removed?

A standard IUD removal is usually quick and performed in your doctor’s office. During the procedure, the healthcare provider locates the IUD strings that extend into the vaginal canal. Using a special tool, they gently pull on the strings, and the IUD’s arms fold up as it slides out of the cervix. Most removals take only a few minutes and cause minimal discomfort, often described as a brief cramp.

You don’t need anesthesia for a typical removal, and recovery is immediate—many people return to their daily activities the same day. However, if the strings cannot be located or if the IUD has moved, the removal may require additional steps.

When Is IUD Removal Needed?

There are several reasons why you may need or want your IUD removed:

• The device has reached the end of its lifespan (3–12 years, depending on type).

• You want to become pregnant.

• You are experiencing side effects such as heavy bleeding, cramping, or discomfort.

• You want to switch to a different form of contraception.

• The IUD has become displaced, embedded, or caused complications.

Your doctor will discuss your options and determine the safest method for removal.

Embedded IUD Removal

Sometimes an IUD becomes embedded in the wall of the uterus. This means the device is stuck and cannot be removed with a simple string pull. Embedded IUD removal requires more care and may involve local anesthesia to reduce discomfort.

In these cases, the doctor may use ultrasound guidance to visualize the IUD and special instruments to gently free it from the uterine tissue. While this can sound intimidating, most procedures are safe and completed on an outpatient basis. Rarely, if the IUD has penetrated deeper into the uterine muscle (myometrium), surgical removal may be necessary.

Hysteroscopy IUD Removal

If an IUD is not visible, has broken, or is embedded in the uterine wall, your doctor may recommend hysteroscopy for IUD removal. Hysteroscopy is a minimally invasive procedure in which a thin, lighted camera called a hysteroscope is inserted through the cervix into the uterus.

This allows the doctor to directly view the IUD and remove it safely. Hysteroscopy is particularly helpful for cases of broken IUDs, missing strings, or when the IUD is lodged in the tissue. Depending on the situation, this may be done in the office with local anesthesia or in a surgical setting with sedation.

Hysteroscopy ensures precision and reduces the risk of complications compared to blind removal attempts.

IUD in Myometrium Removal

In rare cases, the IUD may become embedded not just in the uterine lining, but in the myometrium, which is the muscular layer of the uterus. IUD in myometrium removal is more complex and often requires a surgical approach.

This may be done laparoscopically (keyhole surgery) or, in very rare and severe cases, through open surgery. Such situations are uncommon, but they highlight why it’s important to have regular follow-up appointments after IUD placement and to seek care promptly if you experience pain, abnormal bleeding, or missing strings.

What to Expect After IUD Removal

Most people recover quickly after IUD removal. Here’s what you may experience:

• Mild cramping or spotting for a few hours to a couple of days.

• Return of natural cycles—your period may return within weeks if you had a hormonal IUD that previously reduced or stopped bleeding.

• Immediate fertility—you can become pregnant right away after removal, even if your cycles take some time to normalize.

• Relief of side effects—if you experienced issues like heavy bleeding or pelvic pain due to the IUD, these often improve after removal.

If you are not planning to become pregnant, discuss alternative contraception options with your doctor before or immediately after removal.

Risks and Complications

While IUD removal is usually simple, some risks may occur, including:

• Breakage of the IUD during removal

• Missing strings, requiring advanced techniques like hysteroscopy

• Embedded or migrated IUDs requiring surgical removal

• Rare infections or uterine injury

Your doctor will discuss these risks and recommend the safest method for your situation.

Preparing for IUD Removal

To make the process smoother:

• Schedule your appointment when you are not on your period (unless urgent).

• Take an over-the-counter pain reliever before your appointment to reduce cramping.

• Bring a pad or liner, as light spotting is common afterward.

• Ask your doctor about next steps for contraception or pregnancy planning.

When to Call Your Doctor

Contact your healthcare provider if you experience:

• Severe pain or heavy bleeding after removal

• Fever, chills, or foul-smelling discharge (possible infection)

• Signs that the IUD may have broken or not been fully removed

Prompt medical attention ensures safe recovery and peace of mind.

Key Takeaways

• Most IUD removals are simple, quick, and performed in the doctor’s office.

• Embedded IUD removal or hysteroscopy IUD removal may be required if the device is stuck or missing strings.

• Rarely, IUD in myometrium removal requires surgical intervention.

• After removal, mild cramping and spotting are normal, and fertility can return immediately.

• Always follow up with your doctor if you experience unusual symptoms.