If you’ve spent any time on TikTok or Reddit lately, you’ve probably seen them. People in their bathrooms, sometimes with a pair of clean-ish pliers or just their bare hands, filming themselves as they attempt to tug on those little plastic strings. It looks easy. It looks empowering. It looks like a great way to save a $150 co-pay. But honestly, knowing how to take out an iud safely involves a lot more than just a firm grip and a deep breath.
IUDs are tiny. They are effective. They are also wedged into a muscle that is very good at cramping when it feels threatened.
The intrauterine device (IUD) has become the gold standard for long-term, reversible contraception. Whether it’s the copper ParaGard or a hormonal version like Mirena or Kyleena, these devices are designed to stay put for years. But lives change. Maybe you want to get pregnant, or you’re tired of the spotting, or the five-year "expiration date" is looming. Naturally, the thought occurs: Can I just do this myself?
Technically, the mechanics of a removal are simple. A doctor uses a speculum to see the cervix, grabs the strings with a pair of forceps, and pulls at a specific angle. But "simple" doesn't mean "safe" when you're doing it blindly in a mirror.
The Reality of How to Take Out an IUD at Home
Let’s get the big risk out of the way first. You can’t see what you’re doing. Your cervix isn't exactly front and center; it’s tucked away at the top of the vaginal canal, and its position changes depending on your cycle.
When a clinician like Dr. Jen Gunter—a well-known OB/GYN and author of The Vagina Bible—removes an IUD, she is looking for a specific "give." If the IUD has become embedded in the uterine wall (myometrium), pulling it yourself can cause significant tearing or even a uterine perforation. This isn't just a "bad cramp" situation. We are talking about internal bleeding and potential emergency surgery.
I’ve heard stories of people successfully pulling theirs out. They say it felt like a weird "pop" and then it was over. That’s the best-case scenario. The worst-case involves the T-shaped arms of the device failing to fold upward. If those arms stay locked open while you pull, you are essentially trying to drag a jagged plastic anchor through a tiny, closed muscular opening.
It hurts. A lot.
What the "Self-Removal" Trend Gets Wrong
The internet loves a DIY hack. In 2021, a study published in the journal Contraception actually looked into why people were interested in self-removal. The researchers found that it wasn't just about the money. It was about autonomy. People wanted to feel in control of their own bodies without having to navigate the gatekeeping of the medical system.
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I get that. Truly.
But medical autonomy shouldn't come at the cost of your safety. When you search for how to take out an iud, you’ll find forums where users suggest "bearing down like you're having a bowel movement" to lower the cervix. While this might make the strings easier to reach, it doesn't mitigate the risk of the device being stuck.
When the Removal Goes Wrong (The Medical Side)
Sometimes, even a doctor can't just "pull." This is called a "difficult removal."
If the strings have retracted into the cervical canal—a common occurrence if they were cut too short during insertion—a doctor has to use specialized tools. They might use a "cytobrush" or a tiny hook called an IUD retriever to coax the strings out.
If you try to do this yourself with, say, a crochet hook (yes, people have tried), you risk introducing bacteria directly into your uterus. This can lead to Pelvic Inflammatory Disease (PID). PID is no joke; it can lead to chronic pelvic pain and even infertility if the scarring affects the fallopian tubes.
Real Clinical Steps for Removal
When you go to a clinic, here is what actually happens:
- The Setup: You’ll lie back in the stirrups. It’s the same position as a Pap smear.
- Visualization: The provider inserts a speculum. They need to see the "os" (the opening of the cervix).
- The Grasp: They use long, thin clamps called ring forceps to grab the strings.
- The Pull: They ask you to cough or take a deep breath. This helps relax the pelvic floor. With a steady, firm motion, they pull the device out.
- The Check: The provider looks at the IUD to make sure it’s intact. If a piece of the plastic arm breaks off and stays inside you, it has to be removed, often via hysteroscopy (a camera inside the uterus).
The whole thing usually takes about 30 seconds.
The Cost Factor: Is It Really Cheaper to DIY?
A huge driver for people looking up how to take out an iud is the American healthcare system. If you don't have insurance, a removal can cost anywhere from $50 to $300 depending on the clinic.
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However, under the Affordable Care Act (ACA), most insurance plans must cover the removal of birth control with no out-of-pocket cost. If you are uninsured, organizations like Planned Parenthood offer sliding-scale fees based on income.
Compare a $75 clinic visit to an ER bill for a perforated uterus. The ER visit will cost thousands. It’s a bad gamble.
Pain Management and What to Expect
Let’s be real: insertion is usually much worse than removal. For most people, removal feels like one sharp cramp that lasts for two seconds.
If you’re worried about the pain, you can take 600mg to 800mg of Ibuprofen about 45 minutes before your appointment. Some doctors can also apply a lidocaine gel to the cervix, though it's not always necessary.
After it’s out, you might have some light spotting. Your fertility returns to its baseline almost immediately. If you’re taking it out to get pregnant, you could technically conceive the very next day. If you don't want to get pregnant, you need to have a backup plan (like condoms or starting the pill) ready to go immediately. Sperm can live inside you for up to five days, so if you had unprotected sex three days before removal, you could still get pregnant.
The "String" Problem
Can't find your strings? Stop.
If you can't feel the strings with your fingers, you definitely shouldn't be trying to remove it. Missing strings mean one of three things:
- The strings have tucked up into the cervix (fine, but needs a doctor).
- The IUD has fallen out (expulsion) without you noticing.
- The IUD has migrated or perforated the uterine wall.
In the case of migration, you’ll need an ultrasound to find where the device went. I’ve seen cases where IUDs ended up in the abdominal cavity. You aren't pulling that out at home.
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Actionable Steps for a Safe Removal
If you have decided it is time for your IUD to go, follow these steps to ensure you don't end up in a medical emergency.
1. Check your insurance or find a clinic. Verify your coverage. If you’re worried about the cost, call a local Title X clinic. These clinics receive federal funding to provide reproductive health services at reduced costs.
2. Schedule during your period (Optional but helpful).
Your cervix is naturally slightly more open and sits lower during your period. This can make the removal even easier and faster, though it can be done at any point in your cycle.
3. Have your next step ready.
If you aren't trying to conceive, have your next method of birth control ready. You can often have a new IUD inserted during the same appointment the old one is removed. This is called a "seamless switch."
4. Be honest with your provider.
If you tried to tug on it yourself and gave up because of pain, tell them. They need to know if the device might have shifted or if there’s any trauma to the area.
5. Monitor for symptoms afterward.
While some cramping is normal, seek medical help if you experience:
- Heavy bleeding (soaking a pad an hour).
- Severe abdominal pain that doesn't go away with Ibuprofen.
- Fever or chills.
- Foul-smelling discharge.
Ultimately, your reproductive health is your own. You have the right to decide what goes in and out of your body. But part of that autonomy is making sure you don't accidentally cause long-term damage to yourself. While the DIY videos might make it look like a simple "life hack," the structure of your internal organs is complex. Give your body the respect of professional care. It’s faster, safer, and significantly less likely to end in a viral horror story.