What to Expect When Having Sex With an IUD: Your Most Important Questions Answered

After becoming a parent, whether it’s your first child or your fifth, many of us feel complete with our families—at least for now. The reassurance of preventing unplanned pregnancies is something we all seek. One of the most popular forms of birth control is the IUD (intrauterine device), a T-shaped device about the size of a quarter that is inserted into the uterus. It can be placed at any point during your menstrual cycle, even immediately after giving birth. For every 100 couples using an IUD for contraception, fewer than one will experience an unplanned pregnancy.

The IUD is among the most effective long-term contraceptive methods, and many women prefer it over others. Unlike birth control pills, you won’t forget to take an IUD, nor will you have to worry about incorrect usage like with condoms.

You may have questions such as:

Can my partner feel the IUD during sex?
Is it possible for an IUD to dislodge during vigorous sexual activity?
What are the signs that the IUD is out of place?

Let’s dive into these concerns.

Hormonal vs. Copper IUDs

Understanding how an IUD affects your body is crucial. There are five FDA-approved brands of IUDs, falling into two categories:

Hormonal IUD

This type of IUD releases the hormone progestin, which is similar to progesterone. Depending on the brand, it can be effective for three to seven years. It works by thinning the uterine lining, making it difficult for an egg to implant, and thickening the cervical mucus to block sperm. For those who suffer from heavy or painful periods, a hormonal IUD may lead to lighter menstrual flow.

Copper IUD (Non-Hormonal)

The copper IUD can last up to 12 years. It is an excellent option for individuals who prefer to avoid hormones, as it uses copper to create an environment that is hostile to sperm. However, it can lead to longer and more painful periods, which may affect your sexual desire. If you experience heavy flows, this might not be the best option for you.

Inserting an IUD can be uncomfortable, and some may experience significant cramping. However, sexual activity can typically resume shortly after insertion, with no major issues.

What About the Strings?

During sexual intercourse, your partner is unlikely to notice the IUD itself. After insertion, one or two thin strings, similar to fishing wire, hang down into the vaginal canal. Occasionally, the tip of the penis may brush against these strings, which some find uncomfortable. If this happens, don’t worry—this sensation usually improves after a few weeks as the strings soften and curl around the cervix.

To enhance comfort during sex with an IUD, consider:

Having your partner wear a condom.
Encouraging shallower thrusting.
Asking your doctor to trim the strings, though be aware this could create sharper edges.

Can Rough Sex Cause Issues?

Many people enjoy a more vigorous sexual experience. A common concern is whether rough sex can cause an IUD to become dislodged. According to the American College of Obstetricians and Gynecologists, the chance of IUD expulsion ranges from 2% to 10%, varying by type. This doesn’t mean it will fall out; it could be partially expelled. If you feel something hard protruding from your cervix, it may be a sign of partial expulsion.

While it is possible for an IUD to dislodge, it is not common, and sexual activity is typically not a contributing factor. Most expulsion cases happen shortly after insertion, possibly due to incorrect placement or the body’s rejection of the device. Over time, the likelihood of expulsion decreases.

Signs Your IUD May Have Shifted

Once in place, an IUD usually stays put, but occasionally it may shift. If you suspect this has occurred, consult your gynecologist. About one in every 1,000 placements can result in the IUD perforating the uterine wall.

Watch for these signs:

Severe Pain: Intense pain that occurs outside your normal menstrual cramps could indicate a problem.
Feeling the IUD: You should not feel the IUD at all. If it feels like there is something hard in your cervix, see a doctor.
String Length: You can check the string length with clean hands. They should be at the cervix. If you can’t find them, the IUD may have shifted up; if they feel longer, it may have slipped down.
Pain During Sex: Discomfort during intercourse could signal that your IUD has moved, but it could also point to other conditions like endometriosis, so it’s wise to get checked out.

Most people with IUDs experience no issues, and if shifting occurs, your doctor can assist you. Whether you’re finished having children for the time being or permanently, an IUD is a reliable contraceptive choice for many women. Enjoy your life to the fullest!

Additional Considerations

Can My Partner Ejaculate Inside Me?
The primary purpose of an IUD is to prevent pregnancy by creating an environment in the uterus that is inhospitable to sperm. However, it does not block sperm from entering the vagina, meaning there is still a slight chance (about 1%) of pregnancy.
Do IUDs Cause Weight Gain?
Some users of hormonal IUDs may experience weight gain due to water retention caused by progestin. Other common side effects can include acne, spotting, and mood changes.
What to Avoid After Getting an IUD
After insertion, it’s advisable to avoid sex, swimming, baths, or using tampons for at least one to two days. While you don’t need to be on bed rest, it’s best to avoid strenuous activities for the first couple of days.

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