Is it normal to bleed after sex if you have an intrauterine device (IUD)?

There are a number of reasons you might experience bleeding after sex. If you have an intrauterine device (IUD), you might wonder if bleeding after sex is a normal side effect.

For most people, IUDs don’t cause bleeding after sex. Learn about the benefits and risks of using an IUD, the possible causes of bleeding after sex, and when you should see your doctor.

What is an IUD?

An IUD is a small, T-shaped device. Your doctor can insert it into your uterus to prevent pregnancy. According to Planned Parenthood, less than 1 out of 100 women who use an IUD will get pregnant in a year. That makes it one of the most effective birth control options available.

IUDs protect against pregnancy but not sexually transmitted infections (STIs). To avoid contracting or spreading STIs, use condoms along with your IUD.

The two main types of IUD are copper IUDs and hormonal IUDs. ParaGard is a copper IUD, and Mirena and Skyla are hormonal IUDs.

Copper IUDs

Copper IUDs are plastic devices wrapped in copper. In most cases, you can use a copper IUD for 12 years before you need to replace it. You can even use it as emergency birth control by inserting it within five days after unprotected sex.

Hormonal IUDs

Hormonal IUDs contain the hormone progestin. Depending on the brand, they should be replaced every three to five years. They may help ease menstrual symptoms and may even stop your period completely.

Cost of an IUD

The side effects of using an IUD

IUDs are safe for most women. However, they can cause some side effects.

Side effects during menstruation

After you have your IUD inserted, you may experience heavy periods and breakthrough bleeding for three to six months. This bleeding is usually heaviest in the hours and days after insertion.

Copper IUDs also raise your risk of heavy bleeding, cramping, and backaches during menstruation beyond the first three to six months. Your periods will likely normalize after six months. You should talk to your doctor if they don’t.

Hormonal IUDs tend to make your periods lighter and less painful over time. According to the company that manufactures the Mirena IUD, about 20 percent of women stop having periods after using the device for a year.

Side effects during or after sex

Beyond the initial three to six months, you probably won’t experience breakthrough bleeding with your IUD. It shouldn’t cause bleeding after sex either. If you notice bleeding after sex, contact your doctor. They can help you identify the cause and discuss treatment options.

If you experience pain during sex, speak to your doctor. Your IUD may be out of place. Your doctor can check its placement and reposition it if needed. They can also rule out other possible causes of your pain. Some causes of pain during sex require treatment.

Additional side effects of hormonal IUDs

Hormonal IUDs may cause other side effects, including:

• headaches
• acne or other skin issues
• breast tenderness
• pelvic pain
• weight gain
• mood changes
• ovarian cysts

If you suspect you’re experiencing side effects from you IUD, tell your doctor. They can help you identify the cause of your symptoms. They can also discuss your birth control options. Read more about IUDs and infections.

What can cause bleeding after sex?

If you experience bleeding after sex, it may not be caused by your IUD.

If you haven’t gone through menopause yet, the source of your bleeding is probably through your cervix, which is the lower, narrow end of your uterus. Friction from sex can irritate it and cause some bleeding. If your cervix is inflamed, it can also lead to bleeding. In most cases, occasional bleeding after sex is no cause for concern for premenopausal women.

If you’ve already gone through menopause, the source of your bleeding may be:

• your cervix
• your uterus
• your labia
• the opening of your bladder

Vaginal dryness or more serious conditions may be the cause.

Other possible causes include:

• sex at the beginning or end of your menstrual cycle
• cervical cancer, which you can screen for with routine Pap smears
• cervical ectropion, which is a condition that can affect the inner lining of your cervix
• cervical polyps, which are noncancerous growths that can develop on your cervix
• vaginitis, which is inflammation of your vagina
• STIs, such as herpes or syphilis
• injuries to your uterine lining
• pregnancy

Risk factors to consider

If you’re perimenopausal, take note of bleeding after sex. It’s usually not a sign of a serious health issue. The culprit is more likely irritation. However, bleeding that occurs frequently or heavily may be a sign of cervical cancer or another underlying health condition.

Postmenopausal women should pay careful attention to bleeding after sex. Any bleeding after sex is considered abnormal if you’ve already gone through menopause. You should tell your doctor about it. Vaginal dryness may be the cause, but it’s best to rule out more serious medical conditions.

Speaking with your doctor

Your doctor will likely perform a few tests to help find the cause of your bleeding. Depending on your age and medical history, they may perform the following:

• A pregnancy test to rule out pregnancy. Although IUDs are highly effective, it’s still important to rule out pregnancy if you’re of reproductive age and sexually active.
• A pelvic exam. During this exam, your doctor may also use a device called a speculum to spread your vaginal walls apart and visually examine your vagina and cervix. Your doctor will also insert their fingers into your vagina to check for abnormalities.
• A Pap smear to rule out cervical cancer.

Your doctor may also collect other samples from your vagina, cervix, or uterus to check for STIs or other conditions.

Routine Pap smears and pelvic exams can help you catch some conditions early. Make sure that you go to your routine medical appointments.

How is bleeding after sex treated?

Depending on the cause of the bleeding, your doctor may prescribe a variety of treatments, including:

• If your irritation is from vaginal dryness, they may advise you to use lubricant during sex.
• If your irritation is caused by friction or trauma, they may encourage you to practice gentler sex.
• If you have an STI or other infection, they may prescribe medications.
• If you have cervical cancer or polyps, they may recommend surgery or other procedures.
• If your uterine lining has been injured, they may advise you to avoid sex for two weeks.

Should You Worry About Bleeding After Sex With an IUD?

Bleeding After Sex With an IUD: Common or Concerning?

Many women using IUDs experience occasional bleeding after sex. While it’s usually nothing to worry about, it’s important to understand the causes and when to see a doctor.

What is an IUD?

An IUD is a small, T-shaped device inserted into the uterus for birth control. It’s highly effective, with less than a 1% failure rate per year. There are two main types:

• Copper IUDs contain copper wire to prevent sperm from reaching eggs.
• Hormonal IUDs: Release progestin to thicken cervical mucus and thin the uterine lining, making it difficult for pregnancy to occur.

Bleeding After Sex: IUD or Something Else?

For most women, IUDs shouldn’t cause post-sex bleeding after the initial adjustment period (3-6 months). If you experience it, other factors might be at play:

• Cervical Irritation: Friction during sex can irritate the cervix, causing light bleeding.
• Breakthrough Bleeding: Hormonal fluctuations, especially in the first few months of IUD use, can lead to unpredictable bleeding.
• Other Causes: Underlying conditions like cervical polyps, infections, or injuries could also be responsible.

When to See a Doctor

While occasional spotting might be normal, consult your doctor if you experience:

• Frequent or heavy bleeding after sex
• Bleeding accompanied by pain, cramping, or fever
• Unusual vaginal discharge
• Suspicion of pregnancy (although rare with IUDs)

Postmenopausal Bleeding:

If you’ve gone through menopause and experienced any bleeding after sex, it’s crucial to see a doctor, as it’s not typical.

Diagnosis and Treatment

Your doctor will likely perform a pelvic exam, Pap smear, and pregnancy test to identify the cause. Treatment depends on the underlying reason and may involve:

• Lubricants for vaginal dryness
• Antibiotics for infections
• Surgery for cervical polyps or other abnormalities

The Bottom Line

Bleeding after sex with an IUD isn’t always a cause for concern. However, it’s wise to be aware of potential causes and consult your doctor if you experience unusual symptoms. With proper diagnosis and treatment, you can maintain a healthy sexual life while enjoying the contraceptive benefits of an IUD.

If you’re postmenopausal, tell your doctor about any bleeding after sex.