Forgot to Replace IUD After Intercourse: Pregnancy Risks and Menstrual Effects - Obstetrics and Gynecology

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Forgot to reinsert the contraceptive device after removal?


I have consistently worn my contraceptive ring on time and removed it as scheduled.
Before each sexual intercourse, I always take it out and put it back within three hours, and there have been no issues.
This time, I took it out before intercourse but forgot to put it back in.
There was ejaculation inside, and I remembered about four hours after the intercourse that I forgot to reinsert the ring.
I immediately went to buy emergency contraception because I had been using the ring for about two weeks, and in four days, it would be time to remove it anyway, so I decided not to reinsert the ring.
I would like to know what the likelihood of pregnancy is in this situation.
If I remove the contraceptive ring early, will my period come earlier as well?

Niming, 30~39 year old female. Ask Date: 2023/02/20

Dr. Zhang Kunmin reply Obstetrics and Gynecology


Hello, based on your description, the chances of pregnancy are low but not impossible.
Removing the contraceptive device early may result in an earlier onset of your menstrual period.
Thank you! Wishing you peace and health.
Dr.
Chang

Reply Date: 2023/02/20

More Info


When it comes to the use of an intrauterine device (IUD) for contraception, it is crucial to understand how it works and the implications of forgetting to replace it after intercourse. An IUD is a highly effective form of birth control that can prevent pregnancy for several years, depending on the type. However, its effectiveness can be compromised if it is not in place when needed.

In your situation, you mentioned that you typically remove the IUD during intercourse and replace it shortly afterward. However, forgetting to replace it for four hours after intercourse does raise concerns about the risk of pregnancy. The IUD works primarily by preventing sperm from fertilizing an egg and, in some cases, by preventing implantation of a fertilized egg. If the IUD is not in place during the time of ovulation and potential fertilization, there is a risk of pregnancy.

Since you took emergency contraception (the morning-after pill) shortly after realizing the IUD was not in place, this significantly reduces the likelihood of pregnancy. Emergency contraception is designed to prevent ovulation or fertilization and is most effective when taken as soon as possible after unprotected intercourse. However, it is important to note that emergency contraception is not 100% effective, and its efficacy decreases the longer you wait to take it after intercourse.

Regarding your question about whether removing the IUD early could lead to an earlier onset of menstruation, it is possible. The hormonal IUD can affect your menstrual cycle, often leading to lighter periods or even amenorrhea (absence of menstruation) in some users. If you remove the IUD before the scheduled time, your body may respond by resuming its natural menstrual cycle, which could result in an earlier period. However, this can vary from person to person, and some may not notice a significant change in their cycle.

In summary, while there is a risk of pregnancy if the IUD is not in place during intercourse, taking emergency contraception can help mitigate that risk. If you are concerned about the possibility of pregnancy or changes in your menstrual cycle, it is advisable to consult with a healthcare provider. They can provide personalized advice based on your medical history and current situation. Additionally, if you decide to continue using an IUD, ensure that you follow the guidelines for its use to maintain its effectiveness as a contraceptive method.

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