Scarleteen

Hey Scarleteen team,
I've had the copper IUD for 8 months now and the past two months I've noticed some strange changes. Since having it, I've had the expected side effects of longer, heavier and more painful periods and also some pain during sex - which varies depending on where I am in my cycle. For the first few months I had a week of spotting before my periods and then a week long period but this has calmed down now, so I get two-three days of light spotting then about six days of bleeding. This month I had spotting from the 16th-17th August then was on my period on the 18th-23rd as normal. On the 25th I had some cramping and started spotting again and three days later the spotting hasn't stopped, it actually seems to have gotten heavier. On top of this my pelvic area, mainly the left side, is quite painful and I'm getting some cramping. Last month was similar, I bled from the 16th-28th July. I was worried this could be a sign of pregnancy however my boyfriend and I are extremely careful and always use condoms (the IUD was more of a backup for us to be super safe) so I don't think it is very likely. The IUD strings also seem to be in place. I have no idea what this bleeding could be? It's really starting to worry me..

Bleeding tends to be a pretty good sign of not being pregnant, so you don't have to worry about that. However, you may want to address the fact that you're having unusual bleeding and pain with a healthcare provider, as it may be a sign of infection.

I did think it could be PID but I didn't know if it was likely because I've had the IUD for a while. I've heard people talking about the IUD readjusting after periods, I don't know if it's true but could the fact that I get this weird bleeding after periods be related to that? I will probably see a doctor soon then

Unexplained bleeding, at any time, is one of the most common side effects of IUDs. This may well only be that.

But, for sure, your healthcare provider is the person to check in with to be sure, especially if you worry you may have PID, or - because you express that concern - are not current with your STI testing.

Is it possible to have an STI if my partner and I have never had unprotected sex with each other?

Yes. Safer sex reduces infection risks, it does not eliminate them, alas. The risk is much lower with most infections, but there still always is one.

But it is standard practice for providers to do an STI screening before an IUD insertion because of the big risks IUDs can pose if someone has an infection when inserted or shortly after. So, you likely were already screened eight months ago. If not, and you have never been screened, by all means, since you are sexually active, time for you and your partner to start doing that around once a year, with or without possible symptoms. That is just a matter of standard preventative health for any of us who are or have been sexually active.

Okay. I'll have to get screened then. When I went for the IUD fitting they told me it wasn't necessary to test because we were both virgins before each other and have always used condoms so they said there was no risk.

I am sorry to hear that, that screening really is standard practice no matter someone's sexual history.

Sounds like, too, this clinic then probably did not make clear that STI screenings are an essential part of preventative care for anyone sexually active or who has been, regardless of whether or not partners have had previous partners or are using condoms. Again, these things reduce risks, for sure, but they do not eradicate them, and safer sex as a practice needs to include regular screenings for all partners - paired with barrier use, like condoms. So, even without your concerns about the bleeding, to best take care of your sexual health, you will both ant to start that practice.

For long-term monogamous couples, once a year or even once every other year is what is usually suggested.