Question:  I got the new IUD with the trace of hormone. However, I am constantly spotting. Is this normal?

Dr. Ayoub: My answer to the questions is most likely the individual obtained or had the progesterone “Mirena” IUD placed.  This has a small amount of progesterone that acts mostly locally on the cervical mucosa to help assure sperm are impenetrable to the uterus/fallopian tubes.  Although not the only factor that progesterone has on the reproductive tract or woman’s body, the IUD in general does cause irregular spotting likely decreasing in frequency and quantity the longer the IUD is in place.  The general idea is to advise patients before insertion that there could be up to 6 months of irregular spotting.  However, this could persist a whole year or sometimes longer.  A few individuals will need the IUD removed due to quality of life issues related to irregular bleeding and frustration of dealing with the issue.  A person needs to seek medical care if the IUD strings are not palpated at the cervix monthly, if there is heavy bleeding or pelvic pain associated with its use.  Hope this helps!