Mirena and bleeding after sex

Bleeding after sex may follow friction, vaginal dryness, a sensitive cervix or inflammation. Mirena can also cause spotting, especially after insertion, but it should not be assumed to explain every episode. Chlamydia and other infections can cause bleeding, while cervical dysplasia or cancer are less common possibilities that clinicians consider when bleeding persists or occurs with other warning signs.

The clinician may ask when the device was inserted, whether the threads feel different, whether bleeding happens only after sex, and whether you have pain, discharge, dryness or bleeding at other times. Examination and infection testing may be offered.

Record when the bleeding occurs, how long it lasts and whether sex was painful. Pause penetrative sex if it triggers bleeding or pain until you have advice, and do not remove the device yourself. Arrange a clinical review for a new, repeated or unexplained pattern, even if the bleeding is light.

Seek urgent care for heavy bleeding, severe pelvic or abdominal pain, faintness, fever, foul-smelling discharge, a positive pregnancy test, or concern that Mirena has moved. Prompt review is also needed when bleeding follows sex repeatedly or occurs after menopause.

Ask whether your cervix and vaginal tissues need examination, whether infection testing is appropriate, how Mirena position will be checked, and what treatment could help dryness or irritation if those are contributing.