What causes extremely light or almost no menstrual bleeding after having an IUD inserted?

Apr 20, 2023 Source: Cainiu Health

Dr. Lv Aiming

Introduction

Using the Mirena intrauterine device (IUD), which contains levonorgestrel, suppresses endometrial proliferation and leads to a significant reduction in menstrual flow. Inflammatory stimulation may cause endometrial adhesions, reducing endometrial shedding. Additionally, in patients with polycystic ovary syndrome (PCOS), elevated levels of androgens result in anovulation. In such cases, unopposed estrogen stimulates endometrial proliferation without progesterone counteraction, leading to only minimal endometrial shedding.

After having an intrauterine device (IUD) inserted, having very little or almost no menstrual flow may be caused by physiological reasons or pathological conditions such as endometritis or polycystic ovary syndrome (PCOS). The underlying cause should be identified and treated accordingly. Specific analyses are as follows:

I. Physiological Causes

Women using the Mirena IUD may experience reduced menstrual flow because this IUD contains levonorgestrel, which suppresses endometrial proliferation and causes thinning of the endometrium. This is a normal physiological phenomenon and does not require special treatment.

II. Pathological Causes

1. Endometritis

Poor hygiene after IUD insertion may allow pathogenic bacteria to invade and cause endometritis. If left untreated, inflammatory stimulation can lead to intrauterine adhesions, reducing endometrial shedding and resulting in decreased menstrual flow. Anti-inflammatory treatment under a doctor's guidance with medications such as Fuke Qianjin tablets or levofloxacin capsules is recommended. If adhesions are present, hysteroscopic adhesiolysis is advised.

2. Polycystic Ovary Syndrome (PCOS)

In women who already have PCOS, elevated levels of androgens prevent ovulation. Only estrogen stimulates endometrial proliferation without counterbalancing effects from progesterone, leading to minimal endometrial shedding and light menstruation. Treatment under medical supervision may include medications such as progesterone capsules or ethinylestradiol cyproterone acetate tablets.

Besides the above-mentioned causes, diminished ovarian function could also be responsible. It is recommended to visit a hospital for tests including pelvic ultrasound and sex hormone panel (six items) to identify the specific cause and receive targeted treatment.

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There is blood streaking during the ovulation period every month after having an IUD inserted.

Inserting an IUD (intrauterine device) refers to the placement of a contraceptive device inside the uterus. Experiencing blood streaks during ovulation each month after IUD insertion may be due to normal ovulation, irritation from the IUD, or bacterial infection. During ovulation, as the follicle passes through the vagina and exits the body, slight bleeding or blood-tinged discharge may occur, which is considered a normal ovulatory phenomenon and does not require special intervention.

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Do I have to lie down on the day of getting an IUD?

After having an IUD inserted, whether additional bed rest is needed depends on certain adverse reactions. For individuals without obvious symptoms, normal activities can be resumed after the procedure; absolute bed rest is not necessary, but heavy physical labor should be avoided. For those experiencing significant abdominal pain or bleeding, it is recommended to rest in bed for 1–2 days, resuming normal daily activities only after the body has recovered and discomfort has subsided.