Hello. I had my IUD inserted a week ago. The pain during insertion was pretty bad. I left feeling nauseated and needing to throw up. The next two days, I had pain in my lower right abdomen and I couldn't find the strings. Now the pain in my abdomen is gone but I feel it in my rectum.
Please help. Thank you.
Several questions:
1. What IUD do you have?
2. Was the pain right at the time when the IUD was being placed?
3. If it was just when the IUD was being placed, tell me more about it right then.
4. Did the nausea happen right away or during insertion?
5. Did you feel faint?
6. Did you take anything for the pain?
7. Please try to feel the IUD strings and tell me where/how long they are now.
I am sorry you are having this discomfort. I hope it goes away completely soon.
Her reply on 11-7: “I have the Mirena. I felt a sharp pain when they put the tube in that the IUD travels thru. It felt like a sharp pain towards the right of my lower abdomen. I was about to call it off, but she said putting the IUD thru the tube shouldn't hurt and it didn't. They gave me Motrin before the procedure and used local anesthetic but it hurt my insides. After the procedure, I tried to get up but felt lightheaded and I thought I might vomit. I drove home anyway and the nausea went away after an hour nap.”
”I had fleeting sharp pain and mild bleeding (fresh, not menstrual type) for the next two days. It went away, but I went to my doctor anyway because I couldn’t find strings. The doctor could not find them after an exam, but she said it was not unusual. I went home feeling okay. The next day up and until today (a week later), I have fleeting sharp pains when I have gas or need to make a bowl movement. They are not horrible pains, but enough to take my breath away and make me afraid to go. I think I just want the darn thing out, but I want to know I'm not just being paranoid or sensitive. That's kind of how I felt in the clinic. I know myself and I know this isn't in my head.”
“Thanks for hearing my case and thank you for your help.”
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My impression is that your Mirena IUD may have been inserted through the wall of your uterus. That is that you have had a perforation of your uterus.
If this is the case, it is not protecting you from pregnancy and you should see your doctor immediately! It may require a small operation to remove your Mirena IUD if a perforation has occurred. |
Below is a paragraph written by Dr. David Grimes from the 19th edition of Contraceptive Technology:
Perforation
Perforation of the uterus can occur at the time of IUD insertion; no evidence supports that notion that IUDs “migrate” outside the uterus thereafter. The most important determinant of the risk of perforation is the skill of the person doing the insertion (“the magic is in the magician and not in the wand”). In experienced hands, this risk is 1 per 1,000 insertions or less.
Copper-bearing IUDs found to be outside the endometrial cavity should be removed promptly. Copper in the peritoneal cavity induces adhesion formation, which may involve the adnexa, omentum, and bowel. Laparoscopy is the preferred approach for removal. In contrast, non-medicated and progestin-bearing devices do not evoke similar intraperitoneal adhesions. No clear medical indication exists for removal of T-shaped IUDs not containing copper, although this is commonly done.
One reviewer noted “Perforations do happen, even with experienced and solid clinicians. If a provider has multiple perforations one should re-evaluate technique.
Her reply on 11-7: “Thanks so very much for your medical advice. I plan on having the IUD removed. It’s been nothing but physical and emotional pain.”
You must tell me how things go in the next week.
Her reply on 11-11: “Hello Dr. Hatcher, I went in Tuesday to the doctor and they tried to find the IUD through an exam and could not, including using some hook device. They did an ultrasound and did not see it in my uterus. The doctor said I probably expelled the IUD, but I said that I didn’t. I had looked for it every time I used the bathroom or showered. They did an X-ray and found it in my abdominal cavity. The doctor ordered an emergency laparoscopy and I had it removed a couple of hours later by another ObGyn. So, I was right that something was wrong and luckily I kept pushing the issue with them and contacted you. It was resting against my intestine and could have punctured it. The doctor said there was no bleeding or visible damage to other organs.”
“Thank you for your advice, which was right on. You are basically the only one who took my complaint seriously. But it did not migrate, I knew once she struck that tube in me something was wrong because it hurt like heck and it supposedly should not have. There was nothing in the literature about this complication, plus she never mentioned it, so all of the time I thought I was paranoid. Thanks very much!”
Thank you for your kind words and for the extensive follow-up. I hope the pain has stopped. How are you feeling today?
Her reply 11-13: “I’m feeling great since the surgery. Haven’t felt too much pain except in my shoulder that night, which I read is common. That was 5 days ago and I am pain free! There was one day when I was totally exhausted, but other than that, I feel 100% better.”
Key Words: Mirena IUD, inserted, pain, nauseated, abdomen, rectum, faint, strings, procedure, lightheaded, local anesthetic, bleeding, uterus, perforation, protected, Dr. David Grimes, Contraceptive Technology, copper-bearing IUDs, endometrial cavity, laparoscopy, removal
Reference:
Grimes DA. Intrauterine devices (IUDs) IN Hatcher RA, Trussell J, Nelson et al Contraceptive Technology 19th edition, page 124: Ardent Medial Inc. 2008
Posted 11-15-2009, Updated 11-21-2009, Updated 2-2-2010
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