Bleeding during intercourse with an IUD

Irregular spotting can occur after IUD insertion, but bleeding triggered by contact can also come from dryness, friction, infection, a cervical polyp, or changes on the cervix or vaginal wall. Device movement is another possibility when threads feel different or pelvic pain appears.

The timing of insertion, IUD type, usual bleeding pattern, pregnancy possibility, pain, discharge, odour, and infection exposure all guide the assessment. The clinician may examine the vagina and cervix, look for the threads, offer infection testing or a pregnancy test, and arrange ultrasound if placement is uncertain.

Cervical dysplasia and cervical or vaginal cancer can present with bleeding after sex, although many other explanations are possible. Repeated bleeding therefore needs examination rather than an assumption that the IUD is responsible.

Arrange a sexual-health or gynaecology appointment for recurrent bleeding. Note whether it began after insertion, how much blood appears, whether sex is painful, and whether there is discharge or pelvic discomfort. Take a pregnancy test if your period is late or pregnancy symptoms occur.

Do not pull the IUD threads or attempt to reposition or remove the device yourself. If you cannot feel threads that you normally check, they suddenly feel longer or shorter, or you feel hard plastic, use backup contraception and seek advice promptly. A lubricant may reduce friction, but it should not replace evaluation of persistent bleeding.

Get urgent medical help for a positive pregnancy test with pelvic or abdominal pain, one-sided pain, shoulder-tip pain, dizziness, or bleeding. Pregnancy with an IUD needs prompt assessment to establish the pregnancy location.

Also seek urgent care for severe or worsening pelvic pain, fever, foul-smelling discharge, heavy bleeding, fainting, or marked weakness. Call emergency services if you collapse, become breathless, or cannot travel safely.

Ask whether the IUD is correctly positioned, whether infection and pregnancy tests are needed, whether the cervix looks healthy, when cervical screening is due, and whether you need backup contraception while awaiting results.