What is causing my irregular bleeding while on IUD?

Question

Hello doctor,

Had periods two months before and then had spotting, but no periods. I have an intrauterine device (IUD) as birth control. But I also use morning-after pills every time while having an intrauterine device (IUD).

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Reading through your history, you already have an intrauterine device (IUD) in place, which is itself one of the most effective contraceptives. Adding morning-after pills on top of that every time is unnecessary and actually the main reason your cycles have gone irregular. Those high-dose pills disturb hormones and can cause delayed periods, spotting, or even missed cycles.Hormonal imbalance from repeated use of emergency contraceptives along with an intrauterine device (IUD)is the probable cause.

Investigations need to be done:

Urine pregnancy test, just to be safe. If negative, and still no proper period in one to two weeks, you may need an ultrasound pelvis to check the intrauterine device (IUD) position and uterine lining.
Basic blood tests like thyroid and prolactin can be added if irregularity continues.

Pregnancy (though very unlikely with an intrauterine device (IUD) and pills), thyroid dysfunction, and stress-related delay will be the differential diagnosis.:Pill-induced cycle disturbance will be the probable diagnosis.

I will suggest the following treatment plan:

Stop using morning-after pills while you have an intrauterine device (IUD); it is already sufficient protection.
Allow your body a cycle or two to reset naturally. If periods still do not come for more than six weeks, get tested as mentioned.
If you have heavy bleeding, severe pain, or abnormal discharge, see an in-person gynecologist sooner.

You should follow the following preventive measures:

Stick to one reliable contraceptive (your intrauterine device (IUD) is enough).
Avoid repeated emergency pills; they are not meant for regular use.
Maintain a menstrual diary to track changes.

Please take a urine pregnancy test now and update me with the result. If negative, wait and watch for a couple of weeks. If you still have no periods or you get abnormal bleeding, share back, and we can plan an ultrasound and labs.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.