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Is there a correct or standard length the strings of a ParaGard IUD should be? #525/10

I just got a ParaGard IUD inserted three days ago and I was just wondering
how long my strings should be, as it seems they are a bit long.  In the picture on the pamphlet it shows the strings coming out just past the cervix, but I can feel the end of my strings just a little inside my vagina (when standing).  I did not feel for the strings immediately after insertion, as I had just started my period and my flow is normally heavy at the beginning of my period. It was made even heavier by insertion of the IUD, so I'm not sure exactly how long they were originally. 


The doctor said she left them a little long as they can always be trimmed shorter, but I'm not sure exactly how long they were. It seems they are a little longer today than they were yesterday, but I'm not sure if that's just my imagination or not. 


How far in should I have to reach to feel the strings?  I reached as far as I could and did not feel anything abnormal that might indicate the IUD was being expelled,
but I just want to be sure.

Also, I have mostly been relaxing since getting my IUD and the cramps haven't been too bad. They come and go and are usually brief when they come, but I have noticed that bending and lifting seem to trigger them, as well as if I shift position too quickly (as from sitting to standing or laying to sitting).  Is this normal, or could it be a sign that the IUD is not in the right place and being irritated when I bend?

As your doctor suggested, clinicians have some latitude in how long the strings are left.

The fact that she specifically said she left them a little long, and you feel no hard object with your finger when feeling for the strings, suggests that there is no problem.

There is a range in how long clinicians leave IUD strings if the

length of your strings concerns you, return to your doctor to be sure strings are about as long as
they were after she trimmed them.

There is lots of variation in how long strings are left after IUD is inserted

Here are several recommendations:

4 cm (just less than 2 inches)  [Speroff and Darney; A Clinical Guide for Contraception; Fourth Edition 2005 page 245]


2 cm (just less than 1 inch) [Grimes and Parker Jones; A Clinician's Guide to Levonorgestrel Intrauterine Contraception; ARHP 2001]


About 2 inches (5 cm); [Zieman, Hatcher, Cwiak, Darney, Creinin and Stosur; Managing Contraception 2007-2009; page 85; suggests marking on chart how long strings were left]



Good luck using this marvelous contraceptive!



Key Words:    ParaGard IUD, inserted, strings, length, cervix, period, heavy, trimmed shorter, expelled, cramps, bending, lifting, trigger, laying, sitting, latitude, Speroff and Darney, A Clinical Guide for Contraception, Grimes, Parker Jones, A Clinician’s Guide to levonorgestrel Intrauterine Contraception, Zieman, Hatcher, Cwiak, Darney, Creinin, Stosur, Managing Contraception



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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