What to do if your IUD strings are “missing”

Hysteroscopy and the removal of “Lost” IUD

artworkIntrauterine devices (IUDs) are wonderful forms of contraception. Some IUDs –such as the Mirena and Skyla—have the advantage of helping women with heavy or irregular vaginal bleeding. Another IUD that’s still commonly used is a copper-containing IUD known as the ParaGard.

At the time they’re inserted there are typically 1 or 2 strings that are cut and visible within the vagina. These strings are important – they’re what allows your provider to remove them when it’s time to discontinue them or “change them out”. But every once in a while the IUD strings work themselves back up into the uterus and are nowhere to be found.

When this happens many physicians insist on using “blind” techniques. These methods generally involve placing an instrument into the uterus through the cervix and “searching” around for the IUD or its strings “blindly”. If done in a physician’s office this can be painful. Even when done in an operating room setting this can be a risky procedure if done “blindly”.

Instead we recommend hysteroscopy and IUD extraction. Diagnostic hysteroscopy can be performed under intravenous sedation  and allows for accurate localization of the IUD and its simple and straightforward removal.

When this procedure is performed in our office, under intravenous sedation, it is a quick and painless procedure that typically takes no more than 3 to 5 minutes.

Mirena IUD properly located within the uterine cavity There’s no guessing about it—hysteroscopy reveals all!
Mirena IUD properly located within the uterine cavity
There’s no guessing about it—hysteroscopy reveals all!
The blue arrow points to the “missing” IUD string
The blue arrow points to the “missing” IUD string
This is Paragard IUD. The blue arrow points to the “missing” IUD strings
This is Paragard IUD. The blue arrow points to the “missing” IUD strings

 

 

Birth Control in 2015: Making the Right Choice (Part 3)

Combination Hormonal and Mechanical—Mirena®, Skyla® and Liletta™

IMG_8246The Mirena IUD was first the first hormone-releasing IUD approved by the FDA in 2000.  It is a small, T-shaped plastic device that secretes a small amount of a synthetic progestin called levonorgestrel.  Since there is no estrogen released by the Mirena it is perfect for women who are concerned about the side effects of estrogen—women with clotting disorders or have medical conditions such as hypertension, obesity, cardiovascular disease and diabetes.  The Mirena IUD does not generally stop ovulation.  Instead it works by altering the cervical mucus so that it becomes almost impenetrable by sperm.  It also causes the uterine lining (endometrium) to become thin further decreasing the survival of sperm.

The Mirena IUD is an example of long-acting-reversible contraceptive (LARC).  It provides contraception for up to 5 years.  A second example of a hormone releasing IUD is the Skyla® which was approved by the FDA in 2013.  The Skyla® emits a smaller amount of progestin for 3 years and may be better suited for adolescents who have a slightly smaller uterus than a woman who has already carried a pregnancy to term.  In mid-2015 the Liletta IUD was approved by the FDA.  Liletta is another hormone releasing IUD similar to the Mirena and Skyla. Continue reading “Birth Control in 2015: Making the Right Choice (Part 3)”

Mechanical Contraception (Birth Control in 2015: Making the Right Choice: Part 2)

There are two types of spontaneous mechanical contraception available today that do not contain any type of hormone.  The first is the Paragard IUD which is embedded with copper and is approved by the FDA for up to 10 years of use.  The second—the Essure® device—is a permanent plug that can be placed into the openings of the fallopian tube.  The technique for inserting it is called hysteroscopic tubal occlusions (HTO).

Continue reading “Mechanical Contraception (Birth Control in 2015: Making the Right Choice: Part 2)”

Birth Control in 2015: Making the Right Choice

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With permission from Brenda Washington

Most women in the Rochester area (and United States for that matter!) will end up having 2 children but will spend most of their reproductive lives—about 35 years—trying to avoid an unintended pregnancy. Unfortunately, about half of all pregnancies today are unintended and affect mostly younger women—teenagers and twenty-somethings.

For some women, it seems like there’s no “perfect” contraceptive yet there have never been as many high quality methods available as there are today.  This series of articles will review today’s available methods and may provide some insight about how you can make a good choice for yourself.  We will also share not just the science, but our personal experience in proving these methods of birth control (contraception) over the past few decades.

Continue reading “Birth Control in 2015: Making the Right Choice”