What could cause vaginal bleeding after urination and abdominal cramps while on Mirena?
Irregular shedding of endometrium
The bleeding that you have been experiencing after MIRENA placement is irregular shedding which is common to be seen for 1-2 months in most cases after MIRENA placement. The bleeding is likely to be darkish brown in colour and often continues after peeing of after episodes of increased abdominal pressure.
This can be prevented with the concomitant use of antifibrinolytics like tranexamic acid which can help control and stop bleeding till progesterone hormone level gets adjusted and amenorrhoea sets in.
Unless the bleeding is in excess and amounts to only spotting to mild discharge daily after urination or defecation then there is no actual requirement of MIRENA removal , rather antifibrinolytics can be tried upon.
you may discuss with your treating physician and take an informed decision.
The blood from a bowel movement is bright red and heavy with clots.
remove mirena and opt for pop or GnRH injections.
In that case, MIRENA used is possibly small and you are not the right candidate for MIRENA and hence it should be removed. Migraines are common side effect of progesterones as released by MIRENA. But if bleeding is heavy, then its better to remove MIRENA and switch to continuous progesterone only pills (POP) or GnRH injections monthly.
I am specifically asking whether red/ fresh heavy blood with a couple of clots and cramping and feeling sick is normal after bowl movement.
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