Removing one’s own IUD is apparently “a thing.” There are even YouTube videos of women sharing their experiences. If you can get a medical degree from Google then why not get your OB/GYN residency from YouTube?

All kidding aside, I’m a GYNO and I’m going to explain why you shouldn’t.

It’s not that people can’t technically pull out their own IUDs. It does happen accidentally, albeit rarely. An occasional mishap with a tampon or a menstrual cup is the typical scenario. Considering how uncommon accidental self-removal is (in my 25 + years of experience I have heard of less than five) my guess is those cases are probably situations where the IUD was a little too low in the uterus or the strings were cut way too long to begin with. Longer string means easier to get tangled with something in the vagina.

Pulling an IUD out, when you know what you are doing, is not rocket science. It is technically a very easy medical procedure most of the time. A speculum is inserted and we look at the cervix, grasp the string with forceps, and pull. They usually pop right out, but sometimes you have to tug a little. You need training to know how much to tug and when to stop. The more you have inserted and removed the more you know how much force you can use. Then there is the direction to pull. If you have never instrumented a uterus for any reason and you don’t know what an acutely retroverted and retroflexed uterus (or acutely anteverted and anteflexed) means and how to tell if that’s the case you might not know sometimes you should angle ever so slightly in a certain way as you pull.

Medicine, like many things, is easy until it isn’t and it’s the years of training that tell you when something is going wrong or just isn’t quite right. Pulling out a straightforward IUD doesn’t require 4 years of medical school and then another 4 or 5 years of residency, but identifying when something might not be quite right and knowing what to do about it does. If an IUD has become embedded in the wall of the uterus or in the cervix there is no way to know before you pull. We pull quite gently because an IUD should really just pop out. If there is resistance we don’t know if one of the IUD arms just doesn’t want to collapse or if the IUD is embedded in the uterus or cervix. At this point we stop and wiggle the IUD a little to get a feel. Gynecology is very haptic as much of what we do is blind. Learning the subtle tells of too much or too little pressure or tension takes time and training. Not just training pulling out an IUD, but cumulative training of multiple pelvic exams and other procedures. It’s that training that tells us when to stop and when it’s ok to pull a little harder. It’s the training that tells us when to get a different instrument or when we just need to stop and arrange a hysteroscope (a telescope that goes into the uterus) to remove the IUD while we are looking at it. Blindly ripping out an IUD that won’t budge (i.e. what would happen at home) is less than ideal. You can pull off the strings and then end up definitely needing a more invasive procedure or you might get it out, but lacerating the uterus or cervix as part of the deal.

Fine, you say. I’ll pull and stop if I am pulling too hard.

How will you know if you are pulling too hard if you have never pulled one?

When I needed my own IUD removed I did not do it myself. Even though I have inserted and removed thousands I went to a gynecologist. We all WANT our IUD to slip out easily, so I can tell you not only from years of seeing patients who have done minor (and sometimes not so minor) procedures on themselves and from personal experience that when you are your own surgeon you have inserted a dangerous bias. I have cut corners on myself that I would never dream of doing were I someone’s physician. “Oh sure, that’s sterile enough,” or “It’s only a small cut, really, and it’s not pumping blood so much anymore.” Being your own doctor is about as smart as being your own lawyer.

Let me tell you what happened when my gynecologist pulled out my IUD. It was stuck. As in put-your-foot-up-on-the-side-of-the-bed-for-leverage stuck. My partner at work pulled and here is the most important point – I could tell from the look on her face that there was something wrong before it became uncomfortable. This is important and it bears repeating, I am a gynecologist and I couldn’t tell that something was wrong with my IUD removal until it was already past being wrong. If you are pulling your own string, with less knowledge and no idea how hard is too hard you may not know there’s a problem until it’s really obvious that you have caused one.

There is also the issue of why a woman wants her IUD removed. Sometimes it’s because of the concern over side effects or bleeding issues or another health concern. These are red flags and might suggest other health issues, meaning conditions best checked out by a health provider. When a woman goes to the doctor for an IUD removal these other health issues can be addressed. Then there is the issue for those not wanting to be pregnant post IUD removal. Going uncovered contraception wise is a major risk factor for an unplanned pregnancy, so when you see a doctor or nurse practitioner for removal you should be getting contraceptive counseling as part of the deal. I have seen many women with unplanned pregnancies who thought they could wait after their IUD removal to pick another option as they “weren’t sexually active right now” or “would figure something out.”

What if you want your IUD out because you are planning on getting pregnant? Well, that’s a great opportunity for prenatal counseling. Taking a prenatal vitamin with folic acid three months prior to conceiving significantly lowers the risk of a baby with neural tube defects, but use of preconceptual folic acid in the United States ranges from a dismal 11% to 60%. Yes, overall < 50% of women who take prenatal vitamins start them after their positive pregnancy test. That visit to remove the IUD for the wanted pregnant might help motivate/remind/encourage a woman to pick up some prenatal vitamins on the way out of the office. The visit may also be an opportunity to discuss other health behaviors, like binge drinking and marijuana use, that can negatively affect pregnancy outcome.

Obviously some people have removed their own IUD without issue. It’s also true that many people who have never flown an airplane could sit in the cockpit and babysit the autopilot for an hour, but you know I’d prefer a pilot to be at the controls all the time. Just in case. Lots of things are technically “easy” until they aren’t and I prefer my disasters averted when possible as opposed to damage control. That’s why as a gynecologist I still went to a GYNO to have my own IUD removed.



Join the Conversation


      1. It absolutely can be. I think that’s the common reason to even think of doing it yourself. Both cost and if you live in a rural place like me, access.
        I have a spent IUD in me and I would whole-heartedly be relieved to have a doctor I can trust removing it. I know that is completely better and I probably won’t do it myself. But all my options are bad. The removal cost would be a burden in my current situation — I would still be willing to pay it except that the closest place that might do it is a 3 hour drive away also AND they are all scary white male Utahn gynecologists that, sorry but I am super biased against for this purpose. I don’t feel safe going to them, both because I don’t expect they’ve dealt with a lot of IUDs and know the tricks and will keep me as medically safe as described here, and also I don’t want to have that experience.
        I probably will just let it sit inside me until I eventually go to a city though I’d really like to give my body a break from the IUD’s presence and enjoy having a true period cycle (after three years — Skyla) at least since I can’t afford to get another one. That would be huge to me, but not worth the risk of pulling myself I am concluding.

    1. My girlfriend in Philadelphia was having serious troubles with her IUD today. She had been concerned her IUD was causing problems in the 4-5 months since getting it, but today she was bleeding so heavily and cramping so badly, she felt it had to be addressed. She tried to call the doc and wanted a professional to do it, but if she wanted the procedure to be covered by insurance, they said she’d have to schedule an appointment, which couldn’t happen for days. She is very low-income and is all alone and confident its the IUD causing the problem. She set an appointment in the first opening they had and told her boss she had to leave work. She laid down and tried to let it pass, but it just got worse, so she decided to remove it.
      So there’s someone “fool enough”.
      Most of us in the US recognize our healthcare system is horseshit.

  1. I thought I read an article about this… ah here it is. Interest in and experience with IUD self-removal

    Perhaps less of a money issue (although that and access issues in general can certainly be a problem), but maybe a control / sense of empowerment thing, as suggested by the article? Speculation on my part.

    Interesting that only one in five women were successful in removing their own IUD when given the option. Maybe they didn’t watch the YouTube video? 😉

    Also – minor point, on access – family physicians are perfectly capable of removing IUDs, no need to see a specialist. Unless as Dr Gunter says, it is stuck, which should be referred. Or maybe I am too Canada-centric, where a Gyne referral takes months.

    Unfortunately too few family MDs are comfortable inserting IUDs these days, or worse, counsel nulliparous women / teens that they are contraindicated.

    1. I think family doctors who have a lot of GYN training could easily do it. Some are more comfortable with OB/GYN than others. Also, NPs who do a lot of IUDs as well.

    2. Thank you for the family MD shout out! We definitely can insert and remove IUDs, provide contraception and pre-conception counselling, basically everything listed above except the hysteroscopy for the lost strings/stuck IUD situation. I do think it’s a bit of a culture thing – American specialists seem to do a lot more primary care (I’m thinking gynecology, pediatrics, internal medicine, in particular) that in Canada would be done by a family doc.

  2. Reading this has settled me down a bit. I have skylark which was placed 6 months ago on the 17th of this month. I am concerned with the painful cramps I’m having intermittent to persistent bleeding on a daily/bi-daily basis. I’m always wearing liners and even then my panties don’t seem to survive most of the time. The pain, is usually tolerable. It spiked up to a 7/10 (yeah, I’m a wimp) these last few days which has been bothering me. I am worried it may be perforated. I set an appointment with my nurse practitioner(the gal who placed it) but I missed the appointment. Its at least a 2 week wait. Are these side effects normal for skyla?

  3. Thank you for this! I felt like taking it out myself was my only option rite now but now i see that it’s not worth it.

  4. Well, Dr. Gunter, you can count me as an accidental IUD remover, though I find it hard to believe so few do it accidentally. Less than an hour ago, I was inserting yogurt as a home remedy for BV –uhhh, google it 😦 when I felt the strings. Thinking it could be a ‘lost’ tampon (yes, happened before as well) I pulled on the strings and out came my IUD. As with every issue in my life, I googled “pulled out my own IUD” and here I am on this site. Next google search: “Nausea and dizziness after IUD removal.”

    1. I did mine by accident ,it was in me for 10 yrs and the string was sliding out and I pulled mine off thinking its a tampon , actually it came out with the tampon , few min a go

  5. Thank you for this. I read this *too late* after I pulled my back out trying to get my own IUD out from the self help IUD posts. I couldn’t get a quick drs appt and i felt antsy. (My family doc refused, and my gyne is unavailable due to a change in my employer’s health insurance-i have to get a new one…new patient appts are a longer wait) But after reading your post, I feel fortunate that I wasn’t successful.

    I’m here with muscle relaxers and a heating pad, thankful I didn’t injure myself worse. I’m gonna leave the rest to the professionals. Thanks for taking the time to spell it out for us.

  6. Hi,

    So I am one of those people who took it out themselves.. I had tried to get into my Gyno for a FULL WEEK and also tried to go to City MD and they would not do it. I’ve had it in for over a month and have bled the entire time and was in so much pain I just did it myself..

    Now I’m pretty dizzy and it feels uncomfortable (crampy) but it was WAY worse getting it put in. The gyno who did it unfortunately is not a good doctor nor a good person (giving me little assistance in this emergency as it were) and they did it in a pretty rushed manner.. I am sure they put this thing in wrong in the first place.

    What side effects/symptoms should I look out for? I’m sorry to be such an idiot but I literally hit a wall and couldn’t take it anymore and at that pain for weeks.. (also having no insurance as I started a new job and my new health insurance hasn’t kicked in and the old job insurance had just expired. Literally just expired. Emergency room was not really a viable option 😦 )

    1. Bleeding for a few weeks after insertion is not an emergency, it’s a very common side effect. The same goes for cramping. Bleeding does not mean your doctor is a bad person, and it does not mean the IUD was incorrectly placed.

  7. It felt like getting scratched on both sides with a nail inside my uterus, at the very excellent ob/gyns’ where I had mine removed.
    But it took 2 seconds, speculum insertion and all. No pain pills, no cervical clamp, no trauma, no coughing either! Plus I got a Pap smear before he removed it.
    It would have hurt too much to remove it myself. Save up some cash and splurge to go to a really good ob/gyn to get your iud removed.
    This Doctor I went to, if I had had him throughout my entire reproductive life, I would have had an entirely different life.
    This was the friend and professional I needed and didn’t find until my reproductive years were over.
    Find your most excellent ob/gyn while you are just beginning your journey as young women!

  8. this is great and everything but what about people who have no access to medical help and no money, but a rapidly approaching end-life to their iud? or are possibly even years overdue for having it removed? when is taking it out less of a health risk than just leaving it in because you have no other options?

  9. I removed my own IUD twice. Once, on accident. The second time, intentionally. I am so glad I did. I regret receiving the IUD from a doctor and all advice/prescriptions I have followed from physicians in the past as it has led to pain and illness. I have earned the confidence in my own body and ability to feel its needs and subtle cues because I needed to. I cannot trust doctors because of bad experiences in the medical industry. In my experience going to a doctor means infection, abuse, poisonous drugs, and hugely disproportionate fees. To each their own path.

  10. Thank you so much !!!! I’ve been in a lot of pain due to cysts on my ovaries . So much to where I asked my husband to please just find the string and pull out my IUD … think that since I don’t have a period that it would relieve some kind of pressure. So of course I GOGGLED it!! And your answer was the first to pop up… AND THANK YOU FOR THAT.. because I probably was about to cause more harm than good. Monday I’m calling my OBGYN to figure out what I need to do .

  11. As a medical student honestly considering having my non-OB/GYN medical resident boyfriend remove the darn thing for me, I’m gonna opt to go to the clinic instead, haha. The word “embedded” really sold me. Thank you for your thorough (and kindly non-condescending) article

  12. I absolutely loved the way this was written. Down to earth with valid points and perspective. I have had friends encourage me to remove my own and I can tell you it worries me to do it. Having something go wrong when I’m planning a pregnancy is beyond scary. Thank you for taking the time to write this.

  13. My sister in law pulled her IUD out in November. She said it just popped out with no problems. She did it to avoid the $100 fee the doctor. Also, she wants to get pregnant when her husband gets out if jail. She’s had no noticable problems. Can she have developed a problem without knowing later on while trying to concieve? Or would she already be exhibiting a problem? She shocked us all when she showed it to us. And, honestly, we think she wasn’t being “smart” about doing it herself.

  14. Excellent explanation and well written for those of us that think we are “smart enough” to figure it out. Reading your article prevented yet another DIY potential disaster. Thank you for your continuing contributions to the medical community.

  15. I have a question. I pulled my iud out because i wanted to get pregnsnt and then i backed out. i dont wsnt to tell my GYNO that… i want to get a new IUD and i wonder if its possible even though i pulled it out. Will i be allowed to geta replacement?

  16. Really thorough, but easy to understand. Good analogies. My mom is an OBGYN but I didn’t want her to know I was trying for another child just yet so I WAS going To try it on my own. They had trouble because of the location of my cervix when they inserted my IUD. They actually had to pull it out twice and eventually get a second mirena and use that one instead. So I am probably not a straightforward case and I definitely do not want to damage my reproductive parts, so thank you for explaining this

  17. This was such an easy to read post. My Dr suggested I pull my own out if I decide 9 don’t want it. Considering he didn’t insert it.. and she had difficulty getting it through.. and it took a while of her tell me.. “you’re doing great.. almost done” “sorry I almost got it” I didn’t think it would be safe to remove by myself. I don’t know what he was thinking encouraging me to pull it out by myself plus already having 3 kids. It just seemed so unprofessional. But then again.. He was a med student they have me seeing.

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