Why am I having prolonged bleeding after intercourse?

Question

Hello doctor,

I am a 27-year-old woman. I would like to consult regarding my menstrual periods. My periods were regular two months ago. I had my last period at the beginning of the year. After that, I had unprotected intercourse with my fiancé a month ago. I missed my period, and it was confirmed that I was pregnant. I then used a medical abortion kit for the first time. After that, I experienced bleeding starting, which continued till this month.

Later, I joined the gym, and I again had physical intercourse, and from that same night, bleeding started again. This bleeding has continued for about one week and has not stopped yet. I would like to understand the reason for this prolonged bleeding.

Kindly advise.

Answer 1

Hello,

Welcome to icliniq.com.

I have read the query and understand the concern.

Based on the history, the body has experienced several changes within the recent past, including pregnancy, medication abortion using Mifepristone and Misoprostol, hormonal changes, physical exercise, and sex.

At present, the patient suffers from bleeding, which is most probably related to the abnormal uterine bleeding after a recent abortion procedure. The uterus, as well as hormones, needs some time after the procedure to get adjusted and normalize. This leads to irregular shedding of the uterine lining and causes continuous bleeding. In addition, the physical activities, such as exercising and sexual intercourse, can be the cause of bleeding if the uterus is not healed yet.

Speaking about the timeline of this problem, it is quite normal for the patient to bleed after the abortion procedure. The fact that she resumed the bleeding after intercourse means that it was caused either by hormonal withdrawal or healing of the uterine lining.

This problem can still be considered normal if it is associated with mild to moderate bleeding, no foul-smelling discharge, no severe abdominal pain, and no fever. Also, it is necessary to keep in mind that menstrual periods can stay irregular for about four to six weeks after the abortion.

However, some other things have to be ruled out first, such as retained products of conception, hormonal issues, or even infections on rare occasions. If a woman experiences severe bleeding (one to two sanitary pads in an hour), passing large blood clots, increased pain in the lower abdomen, fever, foul-smelling discharge, or bleeding more than 10-14 days after the miscarriage, medical help must be sought immediately.

It would be wise at this point to carry out a urine pregnancy test to check that your hormone levels are coming down normally. Also, a pelvic ultrasound would be necessary to rule out any tissue left inside the uterus. Intercourse should be avoided until the bleeding has stopped.

Most of the time, this kind of vaginal bleeding usually clears up slowly as the body attains hormonal balance. However, given that you have just had a medical abortion, it is necessary to make sure that your uterus is healed.

I hope you are satisfied with my answer.

Thank you.