I had my Paragard IUD removed today because it was expired. I had it for a total of 10yrs. When they went in to retrieve it they could not see the strings so the removal had to be more "invasive" basically they clamped my cervix then stuck multiple tools inside my cervix into my uterus to retrieve my IUD. It had begun adhering to my uterus & had to be forcefully removed. Thankfully I have a high pain tolerance but even for me it was UNBEARABLLY painful but I soldiered through because if they didn't get it out today I would have had to have surgery where I'd be put to sleep for them to get it out. my strings ended up swirling around my IUD & getting tangled around the top of it. please be very careful with these things I'll NEVER get another one that pain was too much.