Is it normal to experience bleeding after intercourse one year after inserting a Mirena IUD?

Under normal circumstances, if spotting occurs after intercourse one year following the insertion of a Mirena IUD, and the amount is minimal, causes no discomfort, and the IUD position remains stable, it may be considered normal. However, if bleeding is heavy, accompanied by pain, or the IUD has shifted, this is abnormal. If in doubt, it is recommended to seek medical advice promptly. Detailed analysis is as follows:

If only slight blood-tinged discharge appears after intercourse, resolves quickly, and there are no symptoms such as lower abdominal heaviness or foul-smelling discharge, and ultrasound confirms the Mirena IUD is correctly positioned, the bleeding may be normal. In some individuals, the IUD may mildly irritate the cervical mucosa, and slight friction during intercourse can cause minor bleeding. As long as no other abnormalities are present, observation is sufficient and there is no need for excessive concern.

If post-coital bleeding resembles menstrual flow, lasts more than 1–2 days, or is accompanied by painful intercourse, lower back or abdominal aching, or yellowish, foul-smelling discharge, or if examination reveals displacement of the Mirena IUD, the bleeding is abnormal. This could indicate IUD-induced cervicitis, endometrial injury due to IUD displacement, or underlying conditions such as cervical polyps. Without timely treatment, symptoms may worsen.

If bleeding occurs after intercourse one year following Mirena IUD insertion, first record the duration and amount of bleeding; promptly visit a healthcare provider for a gynecological examination and assessment of IUD placement; avoid intercourse in the meantime and maintain good external genital hygiene. Once the cause is identified, follow the doctor’s recommendations for management or treatment.