It is painful to remove the IUD directly after 30 years of menopause. After menopause, the uterus and the cervical canal shrink and become smaller as the ovaries stop producing estrogen and progesterone. It is difficult to remove the IUD through the cervical canal into the uterine cavity with a hook or forceps. The cervix is sensitive to the stimulus of pulling and dilatation, and direct removal of the IUD without loosening and softening the cervix and without anesthesia can be painful. Menopausal women are advised to remove the IUD within one year of menopause, as the uterus and cervix do not shrink significantly during this time, and it is relatively easy to remove the IUD, and it will not be very painful. If menopausal women want to remove the IUD, it is recommended to soften the cervix with medication such as Carboprost suppository or Misoprostol before surgery, and remove the IUD with ultrasound guidance during the surgery, or choose to remove the IUD under intravenous anesthesia if the pain is obvious.