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Dr. Andrew Rynne

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Exp 50 years

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Mirena iud inserted. Having regular, unprotected sex. Started abnormal bleeding with cramps. Pregnant?

Answered by
Dr. Sujoy Khan

Allergist and Immunologist

Practicing since :1999

Answered : 584 Questions

Posted on Tue, 5 Feb 2013 in Early Pregnancy Signs and Symptoms
Question: I'm 27, have had a mirena iud in for four years. For the past month, I have been having regular, unprotected sex, with the same partner. Last week, I broke into hives and have been everyday since. It has ranged in severity, all in different locations (environmental), different times, different foods- having eliminated gluten and dairy from my diet. I was sent to the hospital after work, one evening and have been on famotidine, prednisone and of course benadryl. While, the meds do help to stop the severity of the out break, they have not stopped whatsoever. Now, the hives have been seeming to come on at the same time I have a menstrual cramp and abnormal bleeding. Could it be a pregnancy with the iud?? Any other possibilities... Help!
Answered by Dr. Sujoy Khan 1 hour later
Welcome to Healthcare Magic and thank you for writing to us.

You are having acute urticarial eruptions and is bordering on a chronic course (more than 6 weeks duration is chronic). The benadryl that was prescribed is a very weak antihistamne and does not work very well for acute generalised eruptions.
Once the prednisolone is stopped, the hives will return with a vengeance.

Several underlying disorders need to be excluded, such as an underlying infection especially with the iud. Cramps do occur when histamine release in urticaria is generalised. Also, thyroid dysfunction, abnormal liver functions need to be ruled out that can explain why the hives are not settling.
If all tests are normal, it is idiopathic. For this you need steroids for a week to 10 days, and long-acting high-dose non-sedating antihistamines such as allegra 180mg together with famotidine twice daily for a month.

I hope that was useful.
Best Wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Sujoy Khan 12 hours later
Thank you for your prompt answer.
Throughout the day, hive breakouts has decreased, which I attribute to the prednisone. However menstrual cramps accompanied with bleeding has increased greatly. I've continued to limit consumption of food types and avoid new clothes/fragrances/liquids.

What should I do now? Considering I don't have medical insurance, which is my best route. Follow up with a doctor and hope he/she will take me seriously and do blood work, or finish current scripts, allow the hives to return and go back to the ER?

I apologize for all the questions and plans of action. I need real advice and help.
Answered by Dr. Sujoy Khan 7 hours later
The menstrual cramps (pain) will be lowered by taking pain killers such as ibuprofen (NSAID) after a meal. The bleeding associated can be lowered with tranexamic acid, and you will need a prescription for this. Tranexamic acid also helps with swelling associated with the itching.

There is no need to alter your diet or avoid new clothes/fragrances/liquids as you have tried all these in the past without any effect.

The tranexamic acid, together with antihistamines and famotidine (after finishing the steroids) will help in controlling this acute exacerbation.

Best Wishes.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

The User accepted the expert's answer

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