Ease and difficulty of IUD removal – a prospective study

Posted November 27, 2024

With the aim of describing the ease and difficulty of removing intrauterine devices (IUDs), the INCT Hormona team at Universidade Estadual de Campinas (UNICAMP), in the state of São Paulo, conducted a prospective study of 869 women. The article Prospective Evaluation of Ease and Difficulties of 869 Cases of Intrauterine Devices Removals can be read in full at: https://pubmed.ncbi.nlm.nih.gov/39069127/

The study included women who requested IUD removal, excluding those with partial IUD expulsion in whom the device was protruded at the external os. The study considered IUD removal difficult when it was challenging, including the inability to visualize the device strings extending from the cervical os. Only a small proportion of women reported significant pain during IUD removal. “We found that 702 (80.8%) women had visible strings at the external os and the removals were performed at the first attempt without difficulty in 692 (79.6%) participants. The pain was more intense in cases of difficult removals,” the article says.

According to the unit coordinator, Dr. Luis Bahamondes, the study showed that IUD removal is a simple, painless procedure that can be performed in the physician’s office without any major problems in most cases. “Many women do not use IUDs because they are afraid, they believe IUDs cause pain when inserted or removed, which is only partially true,” he explains.

Dr. Luis Bahamondes believes that medical education is a key element in increasing women’s adherence to IUD use in Brazil. “First of all, we need to train as many health professionals as possible, and to include nurses in IUD placement,” he comments. “IUDs need to be available in most settings, health professionals need to be willing to insert them, and the devices need to be available in the public sector,” he concludes.