Nishmat's Women’s Health and HalachaIn memory of Chaya Mirel bat R' Avraham

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Bleeding on fertility medication

10 July, 2011

Question:

Are you niddah if you are on fertility medication that may cause breakthrough bleeding (especially after relations)? The doctor says it's normal to bleed because the medication makes you easily irritated, but I will be ovulating soon.


Answer:

It is important to distinguish between uterine bleeding, which makes a woman niddah, and bleeding from outside the uterus, which does not.

Some medications may lead to breakthrough bleeding, uterine in origin, which can make a woman niddah. Her status in such cases would depend on the nature of the bleeding. For example, a flow of blood, comparable to a period, would make her niddah. However, breakthrough bleeding often presents as staining, in which case many halachic leniencies apply.  Please see our section on Stains for more information.

Sometimes medications may lead to increased chances of local irritation, leading to bleeding from the outside of the cervix or the vaginal wall.  When bleeding is identified as resulting from such irritation, it does not make a woman niddah.  If that is the concern, you should still use the knowledge gained from reading about the laws of staining to minimize halachic questions.  But if a question does arise, a medical examination may confirm that you have an irritation and enable you to remain tehorah (not in niddah).

In any situation where a woman is experiencing staining, she should be especially careful to wear colored underwear (except during her shivah neki'im), and to avoid looking at toilet paper. Relations should take place on a colored sheet and/or towel, and any wiping afterwards should be done either with a colored cloth or with toilet paper that is discarded without being looked at.

Please be back in touch with any follow-up questions.  Behatzlacha with the treatment.


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