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

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Continuous bleeding after Mirena insertion

9 May, 2017

Question:

Hi, I had the mirena inserted around 3 weeks ago. After it was in for around a week I started lightly staining, for the past week it has increased and I have started bleeding more heavily. I did a little research before and my doctor did tell me I may have spotting for up to 3 months but I assumed it was more on and off I didn't think it would be continuous bleeding without the opportunity to get clean and go to the mikva. Now I have been researching on Facebook groups and I see many people stating they were nidda for the first few months: There is no way my husband and I are prepared for this. This is not an option for me. I am now unsure what to do. Should I get it removed? I tried the paragard in the past but it caused me to have long, heavy periods and I wanted to avoid that. I am not comfortable with taking the pill. Do you have any advice for me? Is there anything I can take that can limit the bleeding?


Answer:

Unfortunately, it is common to experience irregular staining or bleeding for up to 6 months after the insertion of the Mirena as your body adjusts to the IUD and the hormones it secretes. However, once the adjustment period is over, it is common to experience very light periods or even no periods at all.

While some women are able to avoid becoming niddah with the initial staining, other women may experience an actual flow which renders them niddah. However, there are leniencies available (such as reducing the number of bedikot, etc.) that may help a woman immerse despite continued staining. It is important to review the laws of stains, since not all staining will render a woman niddah nor invalidate the clean days.

Given your reluctance to go back to the copper IUD or take birth control pills (although it is important to note that the Mirena also is a hormonal method of birth control, so you may wish to reconsider about pills), we recommend giving the Mirena a few more weeks to see how you adjust before deciding to have it removed. You can try natural remedies for reducing the bleeding (such as lemon juice, alfalfa, etc.) or even speak to your doctor about medication to reduce bleeding such as ibuprofen, bioflavanoids or even a short course of supplementary hormones. You should also be in touch with us or your rabbi for any halachic leniencies to complete the clean days.

If you are not willing to give the Mirena some more time, then you should have it removed. You can discuss with your doctor the use of a diaphragm. When used properly with spermicide it is highly effective and doesn't have any of the side effects of IUDs or hormonal birth control.

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

B'hatzlacha!


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