“Why am I bleeding with an IUD after 2 years?” Are you someone who has been asking this question? Don’t worry. You are not alone.
Many people who use IUDs experience sudden and unexplained changes in their menstrual cycle years after insertion. Many reasons can be responsible for these surprising changes. Knowing what they can be and how to prepare yourself against them will help you navigate a healthy, peaceful lifestyle.
In this article, we will look deeper into the reasons for bleeding after inserting an IUD, what is normal and abnormal in IUD bleeding, what the possible complications are, and when you must visit your healthcare provider for an expert opinion.
Reasons Why Bleeding Occurs 2 Years After Inserting an IUD
There are several reasons that can lead to bleeding 2 years or a significant period of time after the insertion of an IUD. While some bleeding is completely normal, some can raise concerns. A few of the common reasons include:
IUD Displacement: Sometimes your IUD might get displaced or shift, causing discomfort or bleeding. Although this is typically rare, such cases can be concerning since it will reduce the efficiency of the IUD, leading to pregnancy.
Embedded IUD: Sometimes, the displaced IUD can also get embedded in the uterine wall. In this condition, known as an embedded IUD, the device might partially or fully penetrate the uterine wall and get embedded in the myometrium (the muscle layer of the uterus). In some cases, it may even break through the uterine wall and migrate to the peritoneal cavity.
Uterine Changes: After the use of IUDs, your uterine lining may experience changes over time. This is common, especially with the copper IUDs. The presence of copper induces a sterile foreign-body inflammatory reaction in the endometrium, which causes the release of prostaglandins. These are toxic to sperm but can also cause intermittent and heavier bleeding.
Hormonal Fluctuations: A hormonal IUD releases progestin that profoundly suppresses the reproductive environment. It affects your menstrual cycle and thins the endometrium. The hormonal IUDs can reduce bleeding and cramps. For around 20% of users, it completely stops ovulation altogether within the first year (amenorrhea). Although rare, the heavy hormonal fluctuations can sometimes cause bleeding later.
Pelvic Inflammatory Disease (PID): Pelvic or uterine infections such as pelvic inflammatory disease can cause inflammation and ulceration of the endometrium (the inner lining of the uterus). The bacteria may break down the delicate walls of blood vessels located near the uterine wall. This might cause them to rupture and bleed unexpectedly.
Medication Interaction: Certain medications can cause or increase the bleeding after the insertion of an IUD. Anticoagulants or blood thinners, such as aspirin, warfarin, or any oral anticoagulants, can cause heavy bleeding with a normally functioning IUD. Taking medications that increase the breakdown of hormones in your liver while using a hormonal IUD or consuming certain nonsteroidal anti-inflammatory drugs (NSAIDs) can also cause bleeding.
Pregnancy: Although IUDs are highly effective, very rarely, pregnancy can occur with an IUD. This is a high-risk situation that requires immediate medical attention to prevent further complications. In such cases, bleeding can occur due to implantation, cervical irritation, or complications such as ectopic pregnancy or miscarriage.
Medical Conditions: Bleeding after the insertion of an IUD can occur due to severe medical conditions such as the development of uterine polyps, fibroids, cervical or ovarian cancer, endometrial hyperplasia, etc.
After Inserting an IUD: What is Normal vs What is Abnormal?
Inserting an IUD can lead to many symptoms, some of which are perfectly normal while others require medical assessment. These symptoms may include mild to moderate cramping, lower back pain, irregular spotting, or light bleeding for several weeks (usually up to 3 to 6 months).
Cramping: Cramping similar to normal period pain. They might last over 24 to 48 hours and will reduce over time. Mild cramping might also come and go several times within the first few weeks.
Bleeding/Spotting: Daily, irregular spotting can occur during the first 3 to 6 months. Heavy bleeding is normal with copper IUDs, while hormonal IUDs can reduce and lighten the bleeding or even stop it completely.
Stiff Strings: In the beginning, after the insertion of an IUD, you might feel it stiff. However, the device will soften and curl around your cervix over time.
If your cramps are not reducing, worsening, and last longer than usual, or if you are experiencing heavy bleeding for several consecutive hours, shows signs of infection like fever, chills, unusual foul-smelling discharge, or persistent pain during intercourse, you must immediately consult your gynecologist for an expert opinion.
Regular self-examination can help you identify displacement or slipping out of your device. You can also look out for any symptoms that are related to pregnancy. Early diagnosis of these symptoms can prevent a lot of complications.
Conclusion
IUD is one of the most effective contraceptives, commonly used across the world. It shows over 99% effectiveness in preventing unwanted pregnancies. Although many people are worried about the procedure of insertion and removal of IUDs, it involves very simple steps and takes only a few minutes in the clinic.
There are several reasons that can cause bleeding after the insertion of an IUD. Although bleeding in the first 3 to 6 months after the insertion is normal, you must consult a doctor in case of excessive bleeding, abnormal pelvic pain, or discomfort. Since bleeding can be a symptom of any underlying condition, immediate medical attention and a detailed diagnosis might be able to prevent further complications.
FAQ
Bleeding after inserting an IUD heavily depends on the type of IUD you are using. Copper IUDs often cause heavy and painful bleeding after a year. Whereas hormonal IUDs reduce the intensity of bleeding and cramping or even completely stop it.
If your bleeding comes with severe cramping, foul-smelling discharge, or fever, and is heavier than soaking a pad within an hour and lasts longer than 6 weeks, it can be concerning. Be alert, since with heavy blood loss, you might also feel dizzy and faint.
Getting pregnant with an IUD is very rare, with less than a 1% chance. However, if an IUD failure occurs due to displacement or expiration, you might get pregnant, which can lead to severe consequences and may need immediate medical attention.
Unlike the hormonal IUDs, which reduce or even stop bleeding, the copper IUDs can cause irregular bleeding or spotting for the initial 3 to 6 months from the insertion of the device. This can happen either every day or a few days every month.
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