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The strings of my IUD are longer than they were. Should I worry? #1078/7

I have had the Mirena IUD since the end of May 2007. I had my son back in March. In the beginning months after having the mirena inserted, the string felt really short, barely coming out of my cervix. When the doctor inserted the Mirena, my uterus had not fully shrunk down to the normal size.

When I went back for the checkup he said it was in place (sometime in July). I let a couple months go by without checking the strings. Then in September I checked and they were much longer than in the beginning. It even seems as though the string is longer each month. I do not feel the plastic or the knot in the string but I'm very worried that it could be expelling .

I have not been to my doctor and I have had unprotected sex with my husband. My period has been coming at a normal time each month, but is spotty for a couple days, then a full three day mild bleed, then spotty again. I am definitely a worrier to begin with and need reassurance that this is hopefully normal. I think that as my uterus shrank postpartum more string became present outside of my cervix. Please ease my worries.

Wonderful website!  Extremely helpful and informative.

You have had a Mirena IUD since the late May this year. You delivered your son in March. The string felt short, barely coming out of your cervix right after insertion. When your IUD was inserted your uterus was still somewhat enlarged from your pregnancy. 


When you returned for the checkup your doctor told you the IUD was in place. This was sometime in July.  In September, the strings were much longer than in the beginning. It seems to you as though the string becomes longer each month, but you do not feel the plastic or any knot in the string. 


Your concern is that you may be expelling your IUD.  You have not been back to your doctor and you have been having intercourse with your husband with no additional protection


Your periods have been coming regularly each month and consist of spotting for a couple days, followed by a full three days of mild bleeding followed then by some more spotting. You want reassurance that this pattern of bleeding and lengthening of the string is not something to be concerned about. 


Your pattern of bleeding is most likely normal for a woman with this kind of IUD.


You need to see your doctor about the string to your IUD.  It may also be perfectly okay.  For your peace of mind see your doctor and consider using condoms until you are feeling comfortable.


Sometimes the best time spent and health expenditures are simply to learn that everything is okay.  Everything probably is okay in your case but I would still suggest that you get it checked out.


Be sure to let me know what happens and good luck.   You are very smart to be paying great attention to the details!


Key Words:  Mirena IUD, strings, short, cervix, uterus, shrunk down, normal size, knot, expelling, plastic, unprotected sex, period, spotting, mild bleed, postpartum         

Robert A. Hatcher MD, MPH
Emeritus Professor of Gynecology and Obstetrics
Emory University School of Medicine
Atlanta, GA

The directors and owners of this website and any publications and information concerning health matters offered here advise a person with a particular problem to consult a primary-care clinician or a specialist in obstetrics, gynecology, or urology (depending on the problem or the contraceptive) as well as the product package insert and other references before diagnosing, managing, or treating the problem.
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