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Dr. Andrew Rynne

Family Physician

Exp 50 years

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What could cause vaginal bleeding after urination and abdominal cramps while on Mirena?

Answered by
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Dr. Sameer Kumar

OBGYN

Practicing since :2002

Answered : 1656 Questions

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Posted on Tue, 31 Jul 2018 in Women's Health
Question: Hi, I had the miren placed about 7 months ago due to endometriosis and adenomyosis. The mirena has been causing me lots of problems and I am getting it removed next week. Over the last few weeks I am getting vaginal bleeding after a bowl movement or peeing and getting cramps. What could this be?
doctor
Answered by Dr. Sameer Kumar 22 minutes later
Brief Answer:
Irregular shedding of endometrium

Detailed Answer:
Hello,
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.
Regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Sameer Kumar 19 minutes later
I’m getting the mirena removed because of constant pain and migraines which is a different issue to this.

The blood from a bowel movement is bright red and heavy with clots.
doctor
Answered by Dr. Sameer Kumar 5 minutes later
Brief Answer:
remove mirena and opt for pop or GnRH injections.

Detailed Answer:
Hello,
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.
Regards
Above answer was peer-reviewed by : Dr. Nagamani Ng
doctor
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Follow up: Dr. Sameer Kumar 20 minutes later
You are misunderstanding my question, I don’t need your advice about the mirena.

I am specifically asking whether red/ fresh heavy blood with a couple of clots and cramping and feeling sick is normal after bowl movement.
doctor
Answered by Dr. Sameer Kumar 12 minutes later
Brief Answer:
answered

Detailed Answer:
Hello,
To answer you specifically, the answer is-
No, it is not normal at all. This amounts to menorrhagia.
Regards
Above answer was peer-reviewed by : Dr. Kampana
doctor
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Follow up: Dr. Sameer Kumar 8 minutes later
I had a bowel movement 7 hours ago and I am still bleeding and when I pee i am peeing so much blood. Is this an emergency
doctor
Answered by Dr. Sameer Kumar 1 minute later
Brief Answer:
answered

Detailed Answer:
Hello,
If you are bleeding since last 7 hrs and the bleeding is heavy , then this is an emergency and you should definitely report to the ER.
Regards
Above answer was peer-reviewed by : Dr. Vaishalee Punj
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