Increased menstrual flow during the second month after using Mirena

An increased menstrual flow during the second cycle after insertion of a Mirena IUD may be caused by physiological factors or pathological conditions, such as displacement of the Mirena IUD or uterine fibroids. Appropriate management should be based on the individual patient's condition. The specific analysis is as follows:

1. Physiological Factors

The Mirena IUD is a contraceptive device that releases levonorgestrel from its surface. After insertion, it suppresses ovarian function to achieve contraception. However, as a foreign body within the uterus, the device may trigger a local rejection response, leading to heavier menstrual bleeding and prolonged periods. This is considered a normal phenomenon and typically improves gradually over time.

2. Pathological Factors

1) Mirena IUD Displacement

Engaging in intense physical activity after insertion may cause the Mirena IUD to shift out of place. This displacement can lead to excessive contact between the IUD and surrounding endometrial tissues, resulting in local mucosal damage and capillary rupture, which may contribute to increased menstrual bleeding. It is recommended that patients visit a hospital for evaluation and, if necessary, undergo surgical intervention to reposition the IUD.

2) Uterine Fibroids

If a patient has uterine fibroids located near the Mirena IUD, the fibroids may compress the device, causing abnormally high local pressure and contributing to the aforementioned symptoms. In such cases, surgical removal of the fibroids is recommended.

In addition, conditions such as vaginitis, pelvic inflammatory disease, and endometritis may also cause similar symptoms. If patients experience additional symptoms such as abdominal discomfort, they should seek medical evaluation at a hospital promptly to avoid delays in treatment.