Seeking Help: Abnormal Bleeding After RU486 Use and Sexual Activity

Doctor, please help me?

Hello doctor, I took RU486 in August this year, and two months later, after having sexual intercourse, I started experiencing abnormal bleeding.
Every time I have sex, there is a significant amount of bleeding, followed by continuous light spotting.
I went to see a doctor and had a Pap smear; the doctor informed me that I have uterine bleeding but did not provide any further guidance on how to manage it.
I am very worried and wondering if I should seek a second opinion at another hospital or wait for the Pap smear results to come back.
Please help me.
Thank you very much.

bangz, 20~29 year old female. Ask Date: 2007/11/26

Dr. Chen Changfu reply Obstetrics and Gynecology

The use of Ru-486 is classified as a medication-induced abortion.
Clinically, it is commonly observed that after a spontaneous miscarriage, there may be light uterine bleeding that lasts on average about 2-3 weeks.
If a physician has examined the patient, there should be no cause for concern.
It is also advisable to consider a urine pregnancy test in the third week post-abortion as a diagnostic reference for confirming a complete spontaneous miscarriage.

Reply Date: 2007/11/26

More Info

Abnormal bleeding after the use of RU486 (mifepristone) can be a concerning issue, especially when it is accompanied by sexual activity. It is important to understand the potential causes and management options for this situation.

RU486 is commonly used for medical abortion and works by blocking the hormone progesterone, which is necessary for maintaining a pregnancy. Following the administration of RU486, it is normal for individuals to experience bleeding as the body expels the pregnancy tissue. This bleeding can vary in duration and intensity, typically lasting from a few days to several weeks. In many cases, it is expected that the bleeding will gradually decrease over time.

However, if you are experiencing abnormal bleeding, especially after sexual intercourse, it is crucial to seek medical attention. The fact that you have noted an increase in bleeding during or after sexual activity could indicate several possibilities:
1. Residual Tissue: After a medical abortion, some individuals may retain tissue in the uterus, which can lead to ongoing bleeding. This is sometimes referred to as incomplete abortion. An ultrasound may be necessary to determine if there is any retained tissue that needs to be addressed.

2. Hormonal Changes: The use of RU486 can lead to fluctuations in hormone levels, which may affect your menstrual cycle and cause irregular bleeding. It is not uncommon for individuals to experience changes in their menstrual patterns following a medical abortion.

3. Cervical or Uterine Issues: The cervix may be more sensitive after an abortion, and sexual activity could irritate it, leading to bleeding. Additionally, conditions such as cervical polyps or infections could also contribute to abnormal bleeding.

4. Infection: If there is an infection in the uterus or cervix, it could lead to abnormal bleeding. Symptoms of infection may include fever, foul-smelling discharge, or severe abdominal pain.

Given your situation, it is advisable to follow up with a healthcare provider for a thorough evaluation. This may include a pelvic examination, ultrasound, and possibly further testing to rule out any underlying issues. If you are feeling uncertain about the care you are receiving, seeking a second opinion from another healthcare provider or clinic can be beneficial.

While waiting for your Pap smear results, it is essential to monitor your symptoms closely. If you experience heavy bleeding (soaking through a pad in an hour), severe pain, or any signs of infection, you should seek immediate medical attention.

In terms of sexual activity, it is generally recommended to avoid intercourse until you have been cleared by your healthcare provider, especially if you are experiencing abnormal bleeding. This can help prevent further irritation and allow for proper healing.

In conclusion, while some bleeding after RU486 is normal, significant changes or abnormal bleeding warrant further investigation. It is crucial to communicate openly with your healthcare provider about your symptoms and concerns, and do not hesitate to seek additional care if you feel it is necessary. Your health and well-being should always be the priority.

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