An intrauterine device (IUD) is one of the most effective and long-lasting forms of birth control. However, in rare cases, the IUD can become dislodged or fall out—a situation called expulsion.
When this happens, symptoms may include abdominal or pelvic pain, vaginal bleeding, or even noticing the device in your menstrual product. Though it’s uncommon—occurring in about 6% of users—IUD expulsion requires prompt medical attention.

Can an IUD Fall Out?

While IUDs are designed to stay securely in the uterus, expulsion can occur when strong uterine contractions push the device out of place.
Research shows that several factors can increase the likelihood of an IUD falling out, including:

  • Placement soon after vaginal delivery or abortion

  • Having four or more children

  • Heavy menstrual bleeding

  • Obesity or being overweight

  • Younger age at insertion

Though rare, understanding these risk factors helps reduce the chances of expulsion through proper monitoring and follow-up care.

Symptoms Of IUD Expulsion

Some people don’t notice when their IUD falls out. However, common signs include:

  • Abdominal or pelvic pain

  • Unusual vaginal bleeding

  • Cramping during your period

  • Feeling or seeing the device in your menstrual product

IUD expulsion most often occurs within the first few months after insertion or during menstruation, when uterine contractions are stronger.

What To Do If You Think Your IUD Fell Out

You can check your IUD’s placement by feeling for the strings that hang through your cervix into your vagina. Do this once a month, ideally after your period.
Only touch the strings—never try to feel the device itself—and avoid tugging.

See your healthcare provider immediately if you:

  • Cannot find the strings

  • Feel the IUD or notice it feels loose

  • Have pain, abnormal bleeding, or discomfort

Your provider can confirm whether your IUD is still in place using a pelvic exam or ultrasound.

How Does Expulsion Affect Pregnancy Risk?

If your IUD falls out, it no longer prevents pregnancy. Normally, IUDs work by blocking sperm from reaching an egg, and hormonal IUDs also thicken cervical mucus to make fertilization unlikely.
With less than 1% failure rate, IUDs are among the most reliable contraceptive methods—when properly positioned.

However, if the device becomes displaced (not completely expelled), it can still increase risks, especially for an ectopic pregnancy—a dangerous condition where a fertilized egg implants outside the uterus, often in the fallopian tube.

Possible Complications Of IUD Expulsion

If the IUD partially or fully dislodges, it may lead to complications such as:

  • Infection

  • Heavy vaginal bleeding

  • Perforation of the uterus

  • Pelvic inflammatory disease (PID)—a bacterial infection causing inflammation in the reproductive organs

If untreated, these complications may lead to chronic pain, fertility issues, or other serious health concerns.

When To See A Healthcare Provider

Seek medical attention if you suspect your IUD has shifted or fallen out. Never try to reinsert or adjust it yourself.
If the device is partially expelled, it might lodge in the cervix or vaginal canal, causing pain and bleeding.

Schedule a follow-up appointment two to four weeks after IUD insertion to confirm proper placement. During this visit, your provider will check for the two strings that should hang from your cervix into your vagina—indicating the IUD is in place.

If the strings are missing, or if you notice changes in your menstrual pattern, schedule an appointment promptly to prevent complications or unintended pregnancy.