Heavy menstrual bleeding for 15 days without stopping, second month after IUD insertion

Excessive menstrual bleeding lasting 15 days or more in the second month after intrauterine device (IUD) placement may be caused by factors such as drug irritation, IUD displacement or expulsion, or wound infection. Detailed explanations are as follows:

1. Drug irritation

The intrauterine device is a contraceptive tool made of materials such as stainless steel and silicone, with its surface containing a certain amount of progestin. After insertion, the drug is slowly released, maintaining the uterus in a non-conceptive state to achieve contraception. However, the medication may abnormally stimulate the endometrial tissue following the procedure, thereby altering the menstrual cycle and leading to prolonged bleeding as described. Usually, this symptom gradually resolves on its own after some time.

2. IUD displacement or expulsion

If intense physical activity occurs shortly after the procedure, the IUD may not yet be stable and could partially or completely dislodge. This displacement can cause abnormal uterine contractions and severe damage to the local mucosa, potentially resulting in the aforementioned bleeding. Additional symptoms may include abdominal pain and a sensation of a foreign body in the vagina. It is recommended to visit a hospital for evaluation; removal of the IUD may be necessary if complications are confirmed.

3. Wound infection

Poor personal hygiene or frequent sexual intercourse after insertion may introduce external bacteria into the reproductive tract. These bacteria can travel upward to the site of the IUD, invading surrounding mucosal tissues, causing redness, swelling, congestion, or even ulceration, leading to wound infection. Rupture of capillaries at the infected or ulcerated site results in blood leakage, which may explain the prolonged bleeding. Patients are advised to seek medical guidance for treatment, possibly including antibiotics such as cefixime capsules or amoxicillin capsules.

In addition to the above causes, conditions such as uterine fibroids, adenomyosis, or intrauterine adhesions may also contribute. During this period, it is important to balance rest and activity, and adjust clothing promptly according to changes in weather.