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

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Hormonal IUD: What to expect

24 March, 2019

Question:

Hi, I wondered how one deals with the spotting which may occur after insertion of a hormonal IUD? I’m concerned that the niddah status will be continuous due to spotting issues. Can you reflect on experiences of other women you’ve consulted with please?

Thanks so much!


Answer:

Unfortunately, it is common to experience irregular staining for up to 6 months after having a hormonal IUD inserted. This is an important factor that a woman should consider before deciding on this type of birth control. However, not all staining will render a woman niddah nor invalidate the clean days. It is important to review the laws of stains to help deal with any staining issues that may come up.

We have received a range of reports from women describing their experiences adjusting to the hormonal IUD. They range from relatively  easy adjustments with minimal staining, all the way across the spectrum to women suffering from frequent staining that keeps them niddah for months. It is impossible to know in advance how your body will react to the hormones. However, many women find the somewhat difficult adjustment period to be worth it, considering that after that point there are usually very light periods, or even no periods at all.

If you do decide on this type of birth control, we recommend having it inserted while you are tehorah, when it is halachically easier to disregard staining. You may ignore any bleeding you experience during the first 24 hours after insertion. After that, you should take precautions against becoming niddah from any further staining by wearing colored underwear (or disposable pantyliners) and waiting at least a few seconds (ideally 15 seconds) after urinating before wiping. If the bleeding turns into a flow, unfortunately it would render you niddah.

Please feel free to get back to us with any further questions.

This response has been updated to reflect the rulings of our current Rabbinic Supervisor, Rav Kenneth Auman, regarding waiting before wiping.


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