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My Mirena IUD string is sticking out past my vagina. What is going on? #1106/10

My Mirena IUD string is sticking out past my vagina.  I thought that it was the string to my tampon and I pulled on it.  It hurt very, very badly.  What is going on?

Please go immediately to your doctor or nurse practitioner.


It sounds as though your IUD is coming out.


Use condoms if you have sex before you see your clinician, but it sounds as though you may be having too much discomfort to have sex.


Go today!


Good luck!


Her reply on 11-3: “Hello, Dr. Hatcher,

I went to my local doctor and my IUD was 3 inches too low.  My doctor just went ahead and replaced it with a new one.  The looks of my old Mirena seemed as though I had ripped something off when I pulled on it.  This has been a very painful experience!  Hopefully, this time everything will work out great.”


“Thank you for you advice.”

After one expulsion, the risk of a second expulsion is about 30% higher.  This also means, of course, that in 70% of women the second IUD remains in place where it is supposed to be.







Good luck with the second Mirena IUD.  How did that Mirena look when removed?


Thanks for your follow-up and I hope all works out this time.

December 5th, we would like to know how your second Mirena IUD is doing.  Please do let us know.


Her reply on 12-5: “Hi June and Dr. Hatcher,


After I received my second Mirena IUD, I had severe cramping for about a week.  I have not started my period yet, but have had some spotting.  However, when I thought I was going to start my period I kept getting really sharp pains in my stomach just like someone was stabbing me!!!  The pain has stopped for now, but if I keep getting pains like that when it is time for me to start my period, I will be having it removed for good.


Is it possible for the Mirena to be placed too high in the cervix?”

12-10: If it is in the cervix, it is too low.  It should be up in the uterine cavity.


To learn more about the advantages and disadvantages of the Mirena IUD, please go to our website: www.managingcontraception.com and click on

Choices.  You may also order this wonderful new education book from our website or by calling 404-875-5001.

Do you have your copy of Choices yet?


Key Words: Mirena IUD, string, vagina, tampon, pain, clinician, expulsion, condoms, discomfort, sex, removed, replaced, ripped, cramping, spotting, cervix


Grimes DA. Intrauterine devices (IUDs) IN Hatcher RA, Trussell J, Nelson AL. et al Contraceptive Technology 19th  edition, page 124: Ardent Media Inc. 2008

Posted 11-10, 2010, Updated 12-5-2010, December 13, 2010, Updated 1-31-2011

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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