Abdominal Pain and Bleeding After Sexual Intercourse

Abdominal pain and bleeding after sexual intercourse?

Hello Doctor, I had an IUD inserted on February 18th, and my period started on March 6th and ended on the 12th.
I had sexual intercourse on the 13th, 16th, and 20th, and during these times, I experienced severe abdominal pain with deep penetration positions, while normal positions were not painful.
The next day, I noticed light bleeding when I went to the bathroom, just a small amount, and only a little blood when I wiped.
Now, I have a feeling of fullness and dull pain in my abdomen.
Previously, I would feel abdominal pain before my period, which I assumed was due to uterine congestion and swelling.
I am wondering, Doctor, what could be the cause of abdominal pain and bleeding after intercourse around my menstrual period? What should I be aware of? Is this related to the recent IUD insertion? I also felt discomfort similar to menstrual cramps right after the insertion, although I usually do not have menstrual pain.
Thank you for your response.
Additionally, on February 18th, I had a routine Pap smear and ultrasound follow-up for adenomyosis along with the IUD insertion.

Ting Ting, 30~39 year old female. Ask Date: 2019/03/21

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On February 18, I had an intrauterine device (IUD) inserted.
My menstrual period started on March 6 and ended on the 12th.
I had sexual intercourse on the 13th, 16th, and 20th.
During these encounters, I experienced significant abdominal pain during deep penetration, while normal positions did not cause pain.
The next day, I noticed light bleeding when I went to the bathroom; it was minimal, just a little bit of blood when I wiped.
Now, I have a feeling of dull pain and bloating in my abdomen.
Previously, I would experience abdominal pain before my period, which I assumed was due to uterine congestion and swelling.
I would like to ask the doctor: what could be the cause of abdominal pain and bleeding after intercourse around my menstrual period? What should I be aware of?
Answer: The bleeding and abdominal pain after intercourse require a pelvic examination, ultrasound, and Pap smear to determine if they are related to the recent IUD insertion.

Answer: There may be a connection, as discomfort similar to menstrual cramps can occur after the insertion.

Additional information: On February 18, I also had a routine Pap smear and ultrasound for adenomyosis, along with the IUD insertion.

Reply Date: 2019/03/21

More Info

Experiencing abdominal pain and bleeding after sexual intercourse can be concerning and may arise from various underlying causes. In your case, it seems that the discomfort began after the insertion of an intrauterine device (IUD) and subsequent sexual activity. Let's explore the potential reasons for your symptoms and what steps you should take.

Possible Causes of Abdominal Pain and Bleeding
1. IUD Insertion Effects: After the insertion of an IUD, it is common to experience some discomfort, cramping, and irregular bleeding. This is due to the body adjusting to the presence of the device. The pain can sometimes be exacerbated by sexual activity, especially if deep penetration occurs, which may cause the IUD to shift or irritate the uterine lining.

2. Cervical or Uterine Trauma: Deep penetration during intercourse can lead to trauma to the cervix or the uterine lining, especially if there is vigorous thrusting. This can result in minor bleeding and pain. If you notice bleeding after intercourse, it could indicate that the cervical tissue has been irritated or injured.

3. Endometrial Changes: The hormonal changes associated with the menstrual cycle can lead to increased sensitivity and cramping in the uterus. If you have had sexual intercourse close to your menstrual period, the uterus may be more prone to cramping and discomfort due to increased blood flow and swelling.

4. Pelvic Inflammatory Disease (PID): Although less likely if you have been in a monogamous relationship and have no history of sexually transmitted infections (STIs), PID can cause abdominal pain and abnormal bleeding. This condition arises from infections in the reproductive organs and can be serious.

5. Ovarian Issues: Conditions such as ovarian cysts can also lead to pain during intercourse and may cause bleeding. If you have a history of ovarian cysts or other gynecological issues, this could be a contributing factor.

Recommendations for Management
1. Observation: If the bleeding is minimal and the pain is manageable, you may choose to observe your symptoms for a short period. However, keep track of any changes, such as increased bleeding, worsening pain, or the development of new symptoms (e.g., fever, chills).

2. Pain Management: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help alleviate discomfort. However, consult your healthcare provider before taking any medication, especially if you have other health conditions or are taking other medications.

3. Follow-Up with Your Healthcare Provider: Given that you recently had an IUD inserted and are experiencing these symptoms, it is crucial to follow up with your healthcare provider. They may want to perform a physical examination, possibly including a pelvic exam, to assess for any complications related to the IUD or other underlying issues.

4. Avoiding Certain Activities: Until you have a clearer understanding of the cause of your symptoms, it may be wise to avoid deep penetration or vigorous sexual activity that could exacerbate your pain or lead to further bleeding.

5. Discussing Concerns About the IUD: If you suspect that the IUD is causing your symptoms, discuss this with your healthcare provider. They can evaluate whether the device is positioned correctly and whether it is the right contraceptive method for you.

Conclusion
In summary, abdominal pain and bleeding after sexual intercourse can arise from various causes, particularly following the insertion of an IUD. While some discomfort may be normal, it is essential to monitor your symptoms closely and consult your healthcare provider for a thorough evaluation. They can provide personalized advice and treatment options based on your specific situation. Remember, your health and comfort are paramount, and seeking professional guidance is always a wise choice when experiencing concerning symptoms.

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