Why am I still bleeding after having an IUD inserted?
Jul 23, 2025
Source: Cainiu Health
Dr. Zhang Lu
Introduction
In general, "shang huan" refers to the insertion of an intrauterine device (IUD). Prolonged or persistent bleeding after IUD insertion may be caused by factors such as IUD-related irritation, procedural trauma, abnormal device positioning, endometritis, or adenomyosis. It is recommended to seek timely medical consultation at a hospital to determine the underlying cause and receive appropriate treatment. In daily life, to prevent the occurrence of this symptom, adequate rest after the procedure should be ensured.
Generally speaking, "inserting an IUD" refers to the placement of an intrauterine device (IUD). Continuous bleeding after IUD placement may be caused by factors such as IUD irritation, procedural injury, abnormal positioning, endometritis, or adenomyosis. It is recommended to seek timely medical consultation at a hospital to identify the underlying cause and receive targeted treatment. Detailed explanations are as follows:
1. IUD Irritation
Within 1–3 months after IUD insertion, the IUD acts as a foreign body that irritates the endometrium, causing local vascular damage and endometrial shedding. This may manifest as light spotting or brownish discharge, accompanied by mild lower abdominal distension. Usually, no special treatment is required. It is advisable to rest more and avoid strenuous physical activity.
2. Procedural Injury
Minor abrasions to the cervix or endometrium caused by instruments during the procedure may lead to persistent light bleeding after surgery. Typically, the bleeding gradually decreases and has no significant odor. Maintaining external genital hygiene and avoiding sexual intercourse and tub bathing for two weeks is recommended.
3. Abnormal Positioning
If the IUD descends, tilts, or becomes embedded, uneven pressure on the endometrium can cause continuous irritation, resulting in prolonged bleeding accompanied by mild lower abdominal pain. The IUD's position can be confirmed via ultrasound, and the physician may remove or reposition it accordingly.
4. Endometritis
After IUD insertion, bacterial invasion may cause endometritis, leading to endometrial congestion, edema, and increased vascular fragility. Symptoms may include bleeding accompanied by purulent discharge, lower abdominal pain, and fever. Patients may take medications such as levofloxacin tablets or metronidazole tablets under medical guidance. Whether to retain the IUD will be evaluated after inflammation control; removal may be necessary in cases of severe infection.
5. Adenomyosis
In patients with pre-existing adenomyosis, the ectopic endometrium may be stimulated after IUD insertion, leading to worsened bleeding, progressive dysmenorrhea, and increased menstrual flow. Under medical guidance, patients may use ibuprofen sustained-release capsules to alleviate pain. If medication proves ineffective, removal of the IUD and switching to alternative contraceptive methods are recommended.
In daily life, to prevent these symptoms, adequate rest after the procedure is advised, along with avoiding strenuous exercise, maintaining external genital cleanliness and dryness, and refraining from tub bathing and sexual activity to reduce the risk of infection. Regular hospital follow-ups are also recommended to monitor the IUD's position and promptly address any abnormalities.
