How long after a medical abortion can sexual intercourse resume?

After a medical abortion, sexual intercourse should not be resumed immediately. Following a medical abortion, the vagina and uterine cavity sustain varying degrees of trauma and require an extended recovery period. During this time, abstinence is strongly advised. Ideally, intercourse should be postponed until at least one month after the procedure—and preferably only after a follow-up examination confirms that recovery is proceeding normally.

I. Post-Medical Abortion Care:
1. Generally, sexual intercourse should be avoided for at least one month following a medical abortion. Additionally, vaginal bleeding—its volume and duration—must be closely monitored. Prolonged vaginal bleeding is the most common adverse effect of medical abortion and may indicate incomplete abortion. Resuming intercourse too soon poses significant risks: the endometrium has not yet fully healed, blood sinuses remain open, and infection (e.g., endometritis or endometriosis) may develop. If vaginal bleeding persists beyond 7–10 days, a transvaginal ultrasound is recommended to assess intrauterine status and guide targeted treatment.
2. In the absence of complications, normal sexual activity may typically resume approximately two weeks after a successful medical abortion. Because medical abortion does not involve intrauterine instrumentation, bleeding tends to last longer and be heavier than with surgical abortion. Bleeding usually ceases within 1–2 weeks.

II. Important Considerations:
1. After bleeding has ceased, a follow-up visit to the hospital is essential. If ultrasound confirms no retained products of conception and no other symptoms are present, sexual activity may cautiously resume. However, post-abortion hormonal levels have not yet returned to pre-pregnancy baseline, and the cervical os remains partially open—both factors increasing susceptibility to genital tract infection. Therefore, many clinicians recommend waiting until one month post-abortion—or even until after the first post-abortion menstrual period—to resume intercourse.
2. Intercourse should be deferred until after the first post-abortion menstrual period has ended. Surgical abortion inflicts direct trauma and irritation to the endometrium, and also temporarily compromises immune function. Endometrial repair requires time—at least one full month—to restore the uterine lining to its pre-abortion state. Premature resumption of intercourse increases the risk of endometritis and intrauterine adhesions (Asherman’s syndrome), potentially leading to infertility in severe cases.