Persistent Bleeding After IUD Insertion: Causes and Concerns

Uncontrollable bleeding

Hello Doctor: I had an intrauterine device (IUD) inserted on September 21, and I have been experiencing bleeding since then.
I returned to the hospital for a follow-up appointment on October 5, where the IUD was removed (as it had slightly fallen out, which has happened before with previous insertions).
I thought that after removing the "culprit," the bleeding would stop, but it has continued.
In fact, from September 21 to now (October 8), it has been 18 days of continuous bleeding, especially in the last 10 days, which has been heavy, similar to a regular menstrual period (my last period was on September 11, and my cycle is about 26 days).
I can no longer distinguish whether this is menstruation, a side effect of the IUD, or possibly related to the benign fibroids that the doctor mentioned.
The doctor advised me to return in two weeks for the results of my hormone blood test, but I am concerned about excessive blood loss if I wait any longer! Menstrual blood should be similar to regular blood, right? I appreciate your time in responding, thank you!

Ah Hui, 40~49 year old female. Ask Date: 2004/10/08

Dr. Wu Zongcheng reply Obstetrics and Gynecology

Director Wu Zongcheng of the Department of Obstetrics and Gynecology at Tainan Hospital, Ministry of Health and Welfare, replies to Ah-Hui: 1.
After the insertion of the intrauterine device (IUD), taking uterine contraction medication for 1 to 2 days after its removal should help stop the bleeding.
2.
Your bleeding may be due to other combined factors (such as adenomyosis, endometrial hyperplasia, hormonal imbalance, etc.).
3.
Before the examination results are available, it is essential to seek treatment at the hospital; otherwise, severe bleeding could lead to anemia, which is not acceptable.
Tainan Hospital wishes you good health and all the best!

Reply Date: 2004/10/08

More Info

Persistent bleeding after the insertion of an intrauterine device (IUD) can be concerning and may arise from various causes. In your case, it seems that you experienced continuous bleeding for 18 days following the insertion of the IUD, which is longer than what is typically expected. While some bleeding or spotting can occur after IUD insertion, especially in the first few weeks, prolonged heavy bleeding warrants further investigation.

There are several potential reasons for the persistent bleeding you are experiencing:
1. IUD-related Effects: The IUD can cause changes in menstrual bleeding patterns. Some women may experience heavier or prolonged bleeding, especially in the initial months after insertion. This is often due to the body's adjustment to the device. However, if the bleeding continues beyond a few weeks or becomes excessively heavy, it may indicate a problem.

2. Uterine Position or Insertion Issues: If the IUD is not positioned correctly in the uterus, it can lead to complications such as increased bleeding. You mentioned that the IUD had slightly dropped, which could contribute to the bleeding. If the device is not properly placed, it may need to be repositioned or removed.

3. Hormonal Factors: The IUD can influence hormonal levels, particularly if it is a hormonal IUD. Changes in hormone levels can lead to irregular bleeding patterns. If you have underlying hormonal imbalances, they may also contribute to the bleeding.

4. Uterine Fibroids or Polyps: You mentioned that your doctor suggested the possibility of fibroids. Uterine fibroids or polyps can cause abnormal bleeding and may be exacerbated by the presence of an IUD. If you have a history of fibroids, they could be a contributing factor to your current symptoms.

5. Infection: Although less common, an infection in the uterus or cervix can lead to abnormal bleeding. If there are accompanying symptoms such as fever, unusual discharge, or pelvic pain, it is essential to seek medical attention promptly.

6. Other Medical Conditions: Conditions such as endometriosis or clotting disorders can also lead to abnormal bleeding. If you have a history of such conditions, they may need to be evaluated.

Given your situation, it is crucial to follow up with your healthcare provider as recommended. Since you have already undergone blood tests to check hormone levels, the results will help guide further management. If you continue to experience heavy bleeding or develop new symptoms, such as dizziness or weakness, it is vital to seek medical attention sooner rather than later to prevent complications from excessive blood loss.

In the meantime, monitor your symptoms closely. If the bleeding becomes excessively heavy (soaking through a pad or tampon every hour), or if you experience severe pain, fever, or any other concerning symptoms, do not hesitate to seek immediate medical care. Your health and well-being are paramount, and it is essential to address any potential complications promptly.

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