What causes frequent bleeding after wearing an intrauterine device (IUD) for four years?

Generally speaking, "wearing a ring" refers to the placement of an intrauterine device (IUD). Vaginal bleeding commonly occurs four years after IUD placement, which may be caused by factors such as downward displacement of the IUD, hormonal imbalance, pelvic inflammatory disease, endometritis, or cervicitis. If experiencing discomfort, timely medical consultation is recommended. Detailed explanations are as follows:

1. IUD Displacement

After long-term placement in the uterus, the IUD may gradually move downward due to gravity or uterine contractions, irritating the endometrium or cervix and causing bleeding. Prompt medical consultation is recommended to confirm the position of the IUD via ultrasound.

2. Hormonal Imbalance

Hormones released by the IUD may affect the body's hormonal balance, leading to abnormal endometrial proliferation or shedding and resulting in irregular vaginal bleeding. Adjusting the type of IUD or discontinuation, along with choosing alternative contraceptive methods under a doctor's guidance, may be necessary.

3. Pelvic Inflammatory Disease

Infection of pelvic tissues by pathogens can cause pelvic inflammatory disease, resulting in pelvic congestion and edema, which may lead to bleeding, often accompanied by symptoms such as foul-smelling vaginal discharge and lower back pain. Treatment under medical guidance with medications such as Cefuroxime tablets, Amoxicillin capsules, or Fuke Qianjin tablets is recommended.

4. Endometritis

As a foreign body, the IUD may cause endometritis when left in the uterus for a prolonged period, leading to endometrial congestion and ulceration, which can cause bleeding, often accompanied by lower abdominal pain. Treatment under a doctor's guidance with medications such as Metronidazole tablets, Cefixime tablets, or Ciprofloxacin hydrochloride tablets is recommended.

5. Cervicitis

Poor hygiene after IUD placement may lead to cervicitis, causing mucosal damage and bleeding, often accompanied by increased vaginal discharge. Treatment under a doctor's guidance with medications such as Baofukang suppository, Azithromycin dispersible tablets, or Doxycycline hydrochloride tablets may be necessary.

In daily life, attention should be paid to personal hygiene, sexual hygiene, maintaining cleanliness and dryness of the external genital area, and undergoing regular physical examinations.