Pain and bleeding after sex are uncommon side effects of having an intrauterine device (IUD). While an IUD can result in spotting or breakthrough bleeding, it is most likely unrelated to sex. Bleeding after sex is more likely to be caused by other conditions.
What Could Cause Bleeding After Sex?
Until you reach menopause, any bleeding after sex will likely come through your cervix, which is the narrow opening at the bottom of your uterus. Sometimes the friction during sex can lead to bleeding, especially if your cervix is already inflamed or irritated. Another common cause of bleeding after sex is engaging in intercourse close to the beginning of your menstrual cycle. You might also notice bleeding if you have sex without proper lubrication, often due to vaginal dryness.
More concerning causes of bleeding after sex will need medical treatment and should be investigated by your healthcare provider. These include:
- Cervical cancer.
- Cervical ectropion.
- Inflammation in your vagina.
- Cervical polyps.
- Pelvic inflammatory disease.
- Sexually transmitted infections (STIs) such as syphilis.
- Damage to your uterine lining.
Signs that bleeding after having sex might be due to a more serious condition include bleeding that occurs regularly, is heavy, or lasts a while.
What is an IUD?
An IUD is a T-shaped device your local medical provider can insert into your uterus. It is roughly the size of a quarter and can be made of plastic or plastic covered in a thin amount of copper.
Copper IUDs prevent pregnancy by keeping the sperm from reaching and fertilizing the egg. Hormonal IUDs have a similar effect but also release a steady amount of the hormone progestin to thin the uterine lining and thicken the cervical mucus to make fertilization even more difficult. In some cases, it might cause you to stop ovulating completely. Hormonal IUDs can also be used to treat painful and heavy periods.
Why Might an IUD Cause Bleeding After Sex?
While IUDs don’t typically cause bleeding after sex, in some cases they can. Occasionally, an IUD can become displaced, meaning it has fallen partially out of the cervix or the vagina. When your IUD gets displaced, you might experience cramping, discomfort, and possibly bleeding after sex. Some common risk factors that can lead to a higher likelihood of displacement include:
- Having an IUD in your teens.
- Having your IUD placed immediately after delivering a child.
- Having heavy periods.
Once an IUD is dislodged, it will become ineffective. If you suspect you have a displaced IUD, you should contact your medical provider and use a backup birth control method to prevent pregnancy.
Speaking With a Healthcare Provider
When you meet with your local medical provider about your concerns over bleeding after sex, he or she will likely order a few tests to help determine the underlying cause. Even though IUDs are highly effective at preventing pregnancy, your provider will still want to rule it out if you are sexually active.
Your health professional will then likely perform a pelvic exam to evaluate your cervix and vagina visually. He or she might also feel inside with their fingers to check for any abnormalities. You might also receive a Pap smear to rule out cervical cancer. During your pelvic exam, your healthcare provider might collect samples from your uterus, vagina, and cervix to check for possible STIs or other conditions that could be responsible for the bleeding.
If, after your pelvic exam and Pap smear, your healthcare provider finds an abnormality, he or she will likely order further testing, such as a colposcopy. A colposcopy is like a Pap smear, except your healthcare provider will use a more detailed magnifying device to look closely at your cervix. If something looks suspicious, he or she might remove a small sample of tissue for further examination.
Once your healthcare professional determines the cause of your bleeding, he or she can prescribe one or more prevention or treatment options. If vaginal dryness and friction are causing bleeding, you might need to use lubricants during sex. If friction or trauma due to rough sex are causing bleeding, you might want to try sexual positions or practices that limit irritation.
If the cause of your bleeding is an infection or STI, your healthcare provider can prescribe medication to treat it. If he or she detects cervical cancer, you’ll likely be referred to a specialist to develop a treatment plan and remove the cancer from your body.
While bleeding after sex because of an IUD is rare, it is still important to have it checked out, particularly if the bleeding is heavy, is accompanied by abdominal pain, or happens frequently.
Known Side Effects of IUDs
Intrauterine devices are safe and effective ways to prevent unwanted pregnancies. They are, however, associated with mild side effects, such as:
- Pain and cramping during and in the days and weeks following insertion.
- Backaches after insertion.
- Spotting or abnormal bleeding in the months after insertion.
- Lighter, shorter, or absent periods.
- Premenstrual symptoms such as headaches, nausea, acne, and tender breasts.
Rarer side effects to be aware of include:
- The IUD becoming partially or completely dislodged from the uterus.
- Pelvic inflammatory disease.
- Ovarian cysts.
- Ectopic (occurring outside the uterus) pregnancy.
You can discuss these risks and explore other birth control options with your healthcare provider.
An IUD is an extremely effective method of preventing pregnancy and one that has few risks. Speak with your healthcare provider to discuss whether a hormonal-based or nonhormonal option is the best option for your needs.