Hello, thank you for your question. The strings of the Mirena should hang an inch or two outside the cervix (opening of the uterus), but should not hang outside the vagina. Sometimes the doctor cuts the strings a little longer than usual, and some women have a uterus that is close to the opening of the vagina so that strings may be seen. A small fraction of the time when any IUD is placed, the uterus contracts and pushes it part or all of the way out. That can feel very uncomfortable, and is usually best treated by removing that IUD the rest of the way and either placing a new one or using some other contraceptive per the patient s choice. We try very hard to keep the IUD sterile before it is placed in the uterus, so an IUD that has poked out into the vagina for a few days should be removed, not pushed back in. In my practice, I recommend making an appointment sooner rather than later, because I understand that this can be quite uncomfortable. Thank you very much for your question; I hope my answer has been helpful. If you have any further questions, please check back with us. I hope you are feeling better soon.