Does the coil hurt coming out?

Usually not much: for most people, getting an intrauterine device (IUD, often called “the coil”) removed is a quick procedure that causes brief, mild-to-moderate cramping or a sharp pinch lasting a few seconds. Some experience stronger discomfort—especially if the strings aren’t visible or the device is embedded—but serious pain is uncommon and complications are rare. Below, we explain what to expect, what can increase discomfort, and how to make removal easier.

What removal typically feels like

An IUD removal in a clinic generally takes a few minutes. A clinician places a speculum (like during a Pap smear), locates the strings at the cervix, and applies steady traction to slide the device out. Most people describe a brief cramp or pressure as the arms of the IUD pass through the cervix, sometimes followed by short-lived period-like cramps. Light spotting for a day or two is common.

When removal might hurt more

While pain is often mild, certain situations can make removal more uncomfortable. Understanding these factors can help you and your clinician plan for comfort and safety.

• Non-visible strings: Strings can retract into the cervix or uterus, requiring special instruments or ultrasound-guided retrieval.
• Embedment: The IUD can become embedded in the uterine wall, making removal slower and occasionally requiring hysteroscopic removal.
• Cervical sensitivity: People who have not given birth vaginally, or who have a history of painful periods, endometriosis, or adenomyosis, may feel more cramping.
• Anxiety and pelvic floor tension: Stress can heighten pain perception; relaxation techniques can help.
• Active infection or severe cervical stenosis: Rare, but these can increase tenderness and complexity.

Even in these scenarios, clinicians have techniques and pain control options to reduce discomfort and complete removal safely.

How to prepare for a smoother experience

A few simple steps can reduce discomfort and make the visit go faster. These tips are commonly recommended by clinicians and supported by patient reports.

• Take an over-the-counter pain reliever (e.g., ibuprofen 400–600 mg if you can take NSAIDs, or acetaminophen 500–1,000 mg) 30–60 minutes before your appointment.
• Eat a light snack and hydrate beforehand to reduce the risk of lightheadedness.
• Practice slow breathing or bring comfort aids (heat pack for after, headphones, or a support person if allowed).
• Schedule during mid-cycle if possible; some find the cervix slightly softer then, though any time is acceptable.
• Discuss options in advance if you had a difficult insertion, severe anxiety, or prior traumatic exams—local anesthetic or additional support can be arranged.

Preparing ahead reduces stress and can make any brief cramping feel more manageable.

What happens during removal

The removal itself is straightforward in most cases. Knowing the steps can demystify the process and lessen anxiety.

• Speculum placement to visualize the cervix.
• Gentle traction on the IUD strings with forceps.
• Steady removal as the device’s arms fold and pass through the cervix.
• If strings aren’t seen, tools (e.g., cytobrush, alligator forceps) or ultrasound guidance may be used.
• Rarely, if embedded or resistant, referral for hysteroscopic removal or removal under anesthesia is arranged.

Most removals are completed in seconds; more complex cases take longer but are still routinely managed safely.

Pain control options

If you’re concerned about pain, there are several options to make removal more comfortable. Ask your clinician what they offer.

• Pre-medication with NSAIDs or acetaminophen.
• Topical or injected local anesthetic to the cervix (e.g., lidocaine gel or a paracervical block).
• Cervical calming measures (slow breathing, muscle relaxation, topical heat afterward).
• Anxiety support (trauma-informed approach, distraction, or, in select cases, mild anxiolytic if prescribed in advance).
• Planned ultrasound-guided removal for non-visible strings; hysteroscopic removal if embedded.

Most people don’t need numbing injections for routine removals, but it’s reasonable to request them if you’re worried or had a difficult insertion.

After removal: what to expect

Post-removal symptoms are usually mild and short-lived. Understanding the normal recovery course helps you know when to seek help.

• Light cramping for a few hours and spotting up to a couple of days.
• Return to normal activities immediately; use a heat pack or OTC pain reliever if needed.
• Fertility returns quickly; you can become pregnant right away.
• If you’re not switching to another method, use contraception immediately after removal.

If you plan to avoid pregnancy and are not getting a new IUD the same day, arrange backup contraception in advance.

Important timing if you don’t want to get pregnant

There are a few timing nuances around sex and removal that can affect pregnancy risk. Planning ahead avoids surprises.

• If you’re not replacing the IUD, use condoms or abstain for 7 days before removal, or start another method ahead of time. This is especially advised with hormonal IUDs, since sperm can live up to 5 days and protection stops immediately once the IUD is out.
• Sex after removal is unprotected unless you start another method right away. Copper and hormonal IUDs no longer provide any protection once removed.
• If you had unprotected sex in the days just before removal and do not immediately start effective contraception, discuss pregnancy risk and whether emergency contraception is appropriate.

A brief contraceptive bridge before and after the appointment can close any gaps in protection.

Red flags: when to call a clinician

Serious complications after removal are rare, but certain symptoms warrant prompt medical advice.

• Severe or worsening pelvic pain not relieved by OTC medication.
• Heavy bleeding (soaking a pad an hour for more than two hours) or large clots.
• Fever, chills, or foul vaginal discharge.
• Fainting that doesn’t resolve quickly, or persistent dizziness.
• Persistent positive pregnancy test or pregnancy symptoms after removal.

These signs could indicate an infection, retained fragments, or another issue that needs timely assessment.

Bottom line

For most, coil removal is quick and only mildly uncomfortable. Good preparation, clear communication with your clinician, and available pain-control options make a big difference. If your situation is more complex—non-visible strings, prior difficult procedures, or suspected embedment—specialized techniques can keep you comfortable and safe.

Summary

Most IUD removals cause brief, mild-to-moderate cramping and are over in seconds. Discomfort can be higher if strings are not visible or the device is embedded, but effective pain-control strategies and specialist techniques are available. Expect light cramps and spotting for a day or two, and remember that fertility returns immediately—use contraception right away if you wish to avoid pregnancy. Seek medical advice for severe pain, heavy bleeding, fever, or unusual symptoms.

Can I pull my IUD out with my fingers?

The most effective position for self-removal is squatting or lying down. The patient uses their fingers to feel for the IUD strings. Exam gloves can help improve traction on the strings, but are not essential. The patient grasps the IUD strings and pulls firmly towards the opening of the vagina.

How painful is getting the coil out?

Removing the coil can cause slight discomfort, but many find it bearable. If the threads are hard to see, a doctor might use an ultrasound to help take it out.

Can you push your IUD out?

No, you cannot and should not try to push your IUD out yourself; this could lead to serious complications like infection or perforation of the uterus. If your IUD strings feel different, or if you cannot feel them, or if you suspect the IUD has fallen out, use a backup birth control method and contact your healthcare provider immediately for an examination and possible removal by a professional.
 
What to do if you suspect your IUD has moved:

1. 1. Use backup birth control: Immediately start using another method, such as condoms, to prevent pregnancy until you’ve seen your provider. 
2. 2. Contact your provider: Call your doctor or healthcare provider as soon as possible to schedule an appointment. 
3. 3. Do not attempt self-removal: Never try to remove or push the IUD back into place on your own. 
4. 4. Seek professional help: Your provider will be able to check the IUD’s position and remove it properly, which typically involves gently grasping the strings with forceps and pulling, allowing the IUD arms to fold as it slides through the cervix. 

Why you shouldn’t try to remove it yourself: 

• Risk of injury: You could injure your cervix or uterus.
• Risk of complications: Trying to dislodge or remove the IUD yourself can lead to serious complications, such as uterine perforation or embedding of the device into the uterine wall.
• Improper removal: It is difficult to remove the IUD correctly on your own, and you could potentially leave the device inside or partially in the body, which could cause further problems.

Signs that your IUD might be out of place:

• You can no longer feel the IUD strings with your clean finger. 
• The strings feel longer or shorter than when you last checked them. 
• The IUD has fallen out completely. 
• You have unusual pain or discomfort, heavy bleeding, or fever. 

What does it feel like if your coil is coming out?

Signs the IUD is out of place
a string that feels shorter or longer than usual. feeling the IUD during sex. feeling the bottom of the IUD, which can feel like hard plastic, coming out of the cervix. abdominal cramping, pain, or discomfort.