Is it normal to experience bleeding after intercourse following the insertion of an intrauterine device (IUD)?

Generally, Mirena is an intrauterine contraceptive system containing levonorgestrel. If there is heavy bleeding after intercourse following Mirena insertion, accompanied by other symptoms, it usually is not normal. However, if the bleeding is light and no other symptoms are present, it typically is considered normal. If discomfort occurs, timely medical consultation at a regular hospital is recommended. Detailed explanations are as follows:

If heavy bleeding occurs during intercourse after Mirena insertion, especially accompanied by abdominal pain, fever, or abnormal vaginal discharge with an unpleasant odor, this is usually considered abnormal. It may be caused by abnormal positioning of the intrauterine device (IUD), which irritates the endometrium or cervical tissue, leading to increased local damage. It could also be due to inflammation caused by infection after IUD insertion, resulting in congestion and fragility of mucosal tissues, making heavy bleeding during intercourse more likely. Cervical lesions should also be considered. If left untreated, these conditions may worsen discomfort and even lead to more serious health risks. Therefore, prompt medical evaluation is necessary to identify the cause and provide targeted treatment.

If only slight bleeding occurs during intercourse after Mirena insertion, and there are no other symptoms such as abdominal pain, fever, or abnormal discharge, it is generally considered normal. This is because Mirena, as a foreign body placed inside the uterine cavity, may cause some irritation to the endometrium, resulting in minor injury or irregular shedding of the local endometrial lining, which may lead to slight bleeding during intercourse. This condition usually subsides gradually as the body adapts to the presence of the IUD, and no excessive concern is necessary.

After Mirena insertion, any postcoital bleeding should be closely observed, including the amount and duration of bleeding, as well as whether other discomforts are present. During the period following insertion, it is important to maintain good hygiene of the external genitalia, washing daily with warm water, and avoiding the use of irritating cleansers or frequent vaginal douching.