Why does an IUD migrate and stop working without warning?

Question

Hello doctor,

I am 33 years old and had an IUD placed two years ago. I recently found that it had shifted. I had cramps and spotting, but ignored them. Ultrasound showed malposition.

Why does an IUD at 33 sometimes migrate and stop working without warning?
Can uterine shape or contractions cause this?
Does migration suddenly increase pregnancy risk?
Should imaging be done routinely?
I feel shaken because I trusted it fully. How can I know it is placed correctly long-term?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and understood your concern.

With an intrauterine device, movement or malposition can occur even after a period of correct placement, although it is not very common. It can be related to factors like the shape or size of the uterus, strong uterine contractions, especially during menstruation, partial expulsion that goes unnoticed, or how the device initially settles after insertion. Symptoms like new cramping or spotting, which you noticed, are often the only clues.

When an IUD (intrauterine device) shifts out of its optimal position, its effectiveness can decrease, so the risk of pregnancy can increase without obvious warning. This is why evaluation is important if symptoms change.

Routine imaging is not typically done if there are no symptoms, but checking the strings regularly and having an examination or ultrasound if anything feels different is the usual approach. An ultrasound is the best way to confirm the position when there is concern.

Going forward, if you choose another intrauterine device, your clinician may review uterine anatomy more carefully, ensure correct placement at insertion, and possibly schedule a follow-up check, especially given your experience.

Many people continue to use IUDs successfully after a malposition, but it is also reasonable to explore other contraceptive options if this has affected your sense of safety.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.