Why does bleeding occur after having an IUD inserted?

Generally, "carrying a ring" refers to the placement of an intrauterine device (IUD). Bleeding after IUD insertion may be caused by the IUD adaptation period, changes in the menstrual cycle, IUD irritation, coagulation disorders, or endometritis. If discomfort occurs, timely medical attention is recommended. Detailed explanations are as follows:

1. IUD Adaptation Period

After insertion of an IUD, the endometrium requires a period of time to adapt to the presence of a foreign body, during which mild bleeding may occur. Bleeding during the adaptation period does not require special treatment and discomfort can be relieved with warm compresses.

2. Menstrual Cycle Changes

After IUD placement, some women may experience changes in their menstrual cycle, including prolonged menstruation, increased menstrual flow, or bleeding outside the menstrual period. It may also be accompanied by worsening dysmenorrhea or premenstrual syndrome symptoms. Observation for several months is generally recommended, as bleeding often resolves on its own. If bleeding is severe or persistent, timely medical attention is advised.

3. IUD Irritation

If the size of the IUD does not match the dimensions of the uterine cavity, it may irritate the endometrium, causing short-term bleeding after insertion. It may also be accompanied by mild abdominal pain or discomfort. Observation for a period of time is recommended; if symptoms persist or worsen, medical evaluation is necessary, and replacement with a suitable IUD or adoption of alternative contraceptive methods may be required.

4. Coagulation Disorders

A deficiency in clotting factors or abnormal platelets may lead to coagulation disorders, making blood difficult to clot within blood vessels, possibly resulting in prolonged bleeding time. Symptoms may also include gingival bleeding or epistaxis. Treatment under medical guidance with medications such as tranexamic acid injection, vitamin K1 injection, or heparin sodium tablets may be recommended.

5. Endometritis

Poor hygiene or infection risk following IUD insertion may lead to inflammation of the endometrium, presenting as abnormal bleeding, accompanied by lower abdominal pain, fever, and abnormal vaginal discharge. It is recommended to follow medical advice for treatment with medications such as amoxicillin capsules, metronidazole tablets, or azithromycin dispersible tablets.

In daily life, if bleeding occurs after IUD insertion, it is important to maintain external genital hygiene and avoid sexual intercourse. If the bleeding volume is large or persists for a long time, consultation with a doctor is advised to assess whether adjustment of the IUD's position or change in type is necessary.