Do IUDs limit kinky play?

I'm about to get an IUD (Mirena, to be exact) and my boyfriend and I engage in, um, some intense types of play (to say the least). Previously, I had an implant in my arm so it was never a question, but now we're curious about what is and isn't OK with an IUD. Is there anything we should be worried about? What about fisting? All sorts of insertable/inflatable toys? I've never had kids so I know that perforation is a slightly higher risk for me, though not a huge one by any means. We're curious!

I love that you start out coy about your, er, um, "intense play" and then come right out with a question about fisting and inflatable toys. I imagine there would be even greater hemming and hawing if you were to try to broach the subject face-to-face (or face-to-cervix, as it were) with your OB-GYN, which is surely why you're coming to me instead. It seems to me that most of us treat medical professionals with kid gloves when it comes to our sexual health, as though we'll shock them if we reveal what we really get into behind closed doors (maybe because we're privately shocked by, and embarrassed of, our sexual selves). There's this sense that introducing a kinky topic like inflatable vaginal toys in their staid, erudite sanctum is downright improper -- but it's not. I encourage you to press through the fear and ask away!

Preaching aside, I took the basic question of whether it's possible for an IUD to become dislodged through vigorous, deeply penetrating penis-in-vagina sex to David Grimes, an OB-GYN and vice president of Family Health International. He told me in an email, "The answer is no. The IUD is in the uterus, the penis is in the vagina. Two different compartments." The same is true even of fisting or large toys. Deborah Nucatola, senior director for medical services for Planned Parenthood Federation of America, told me by phone, "The IUD is completely in the uterus. It's nothing to be...

Now, the soft, flexible strings of the IUD, which are used for removal and to regularly check that the device is still in place, do extend beyond the uterus into the cervix and vaginal canal, but they are "rarely pulled by intercourse," says Tania Basu, an OB-GYN at University of California, San Diego's Medical Center. Just make sure your partner doesn't pull the strings with a stray finger; and if they're in any way uncomfortable for you or your partner you should simply ask your doc to trim them.

Might I add that there's nothing like some old-fashioned medical diagrams to put you at ease; it's remarkably easy to be out of touch with our own anatomy. (I swear to you, I'm amazed every time I see a detailed rendering of the female reproductive system.) Sexologist Shanna Katz tells me in an email, "I encourage folks to reach up and feel the string prior to sex play (and also have their partners feel for it, so they have an idea of its size and location) and to check again after sexual activity is over."

For the record, the experts that I spoke with were thoroughly un-phased by your question. The important lesson here isn't so much that you can engage in "intense" play while on an IUD, but that you can ask your doctor all about it; and if it ends up that you aren't the only one blushing and stuttering, it might be time to look for another provider.

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