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Women are posting videos removing their IUDs at home. Is it safe? Doctors discuss

'If you come across an OB-GYN who goes against what you want, then it’s probably time to find yourself a different doctor.'
/ Source: TODAY

There’s a new TikTok trend that doesn’t involve milk crates or dancing. Some women are removing their IUDs and sharing videos of it on TikTok and YouTube. The thought of grabbing the IUD strings and yanking the medical device through the cervix might cause many to cringe, but some wonder if it’s a safe option to pursue.

The answer?

Not really.

“Probably it’s more safe than not safe,” Dr. Gloria Bachmann, an OB-GYN and the director of the Women’s Health Institute at the Rutgers Robert Wood Johnson Medical School told TODAY. “It is better to do it in a controlled environment … When we take it out in the office, everything is visualized as you are doing it more or less blindly (at home).”

And doctors are better equipped to handle any sort of bleeding or complications that might occur when it’s removed.

“If it’s embedded in the muscle layer of the uterus, which can happen, it can cause a lot more bleeding, a lot more pain and it can actually bring the uterus down with it, which is not something that one would want,” Bachmann said.

Dr. Anar Yukhayev said that removing one’s own IUD is unsafe. He urges people to have a medical professional remove an IUD, a procedure that normally takes less than 10 minutes in an office.

“When (a doctor’s) grasping the string and you’re using forceps most of the time, the IUD pops right out. Sometimes you have to use a little bit of force. The thing is, you have to know exactly how much force to use,” the OB-GYN at Long Island Jewish Medical Center told TODAY. “If you’re using too much force that might mean something is wrong, like the IUD might be stuck.”

Tugging on stuck IUD could cause bleeding and damage and cause an “emergent issue.”

“When you pull it, you can actually lodge it in a different part of the uterus and make the embedding of the IUD even worse,” Yukhayev said. “That’s one of the issues I can think about why it’s not a good idea, or it’s risky, actually dangerous.”

In the videos women sometimes say that they want their IUDs removed because they experience bleeding and cramping, which Yukhayev believes means that their IUDs are in the wrong position already.

“When a woman has these symptoms with an IUD in place that might be because the IUD is mispositioned already. So if it’s positioned in the wrong way that can cause cramps, it can be painful, sometimes the bleeding is a little bit off,” he explained. “If you’re already starting off in a place where it’s not positioned (properly) trying to then pull it out yourself … you can make a bad matter worse.”

And sometimes people have uteruses that tilt forward or backward, which might make removing an IUD even trickier.

Some say they had no choice but to remove their own IUDs because their doctor refused to do it without them choosing another birth control or they couldn’t afford the removal fee. As for cost, Yukhayev urges patients to talk with their doctor’s office about sliding scale payments based on a person’s ability to pay. The experts feel confused by doctors who refuse removal, though.

“Why the provider said they wouldn’t remove it, I am unsure of that. Unless a string cannot be found or unless the provider did not do that procedure or there were concerns there might be excessive bleeding,” Bachmann said. “It may not be done that exact same day sometimes. But it will be done. I’m not sure why a provider wouldn’t do it.”

Yukhayev said ideally patients should be engaged in shared decision making with their doctor where the doctor listens to their patients' concerns and finds a solution that works for the patient.

“I see my job as a physician to tell the patient what I think is going on, what the risks and benefits are, what the options are and for us together to come to a decision that we’re both comfortable with. Now, I can’t ever imagine myself being in a position where a patient really wants their IUD out and I tell them, ‘No,’” he said. “If you come across an OB-GYN who goes against what you want then it’s probably time to find yourself a different doctor.”

IUDs remain a safe, long term birth control option for many. A progesterone IUD prevents pregnancy for anywhere between five and seven years while a copper, non-hormonal IUD or copper offers 12 years protection. But just because they’re popular doesn’t mean they’re right for everyone and if women are experiencing problems they should talk to their doctor about removing it. Still, many have an IUD and don’t even remember they have it, making a great option for them.

“Not only is it a good birth control method but for many women who have heavy periods, it’s actually used to decrease the amount of bleeding. So you’re not becoming iron deficient,” Bachmann said. “It’s a very safe method.”