vaginapagina | Bleeding after sex with Mirena IUD (Reply)

Hi VPers. Background info: 29-year-old nulliparous cis female, in a long-term monogamous relationship with my cis male fiancé. He has been my only partner, and he had one partner before me.

I had a Mirena IUD inserted in summer 2010. It seems to have been quite happily hanging out since then, no problems as far as I could feel. The strings were never trimmed, sometimes they poke my partner during sex. I haven't had a period in several months at least.

Maybe a year ago I started noticing intermittent light spotting sometimes after sex. It seemed to happen more often if it had been more than a week since PIV sex, so I assumed my vagina was just readjusting. If I did have spotting I would usually get light cramping too. Several weeks ago I had a week or two where I was cramping moderately for no reason (no spotting at all) and that was weird, but went away.

Today we had great sex for the first time in 1 days and when I went to the bathroom afterward I was bleeding - not just light spotting but quite a bit of blood. I had to wipe at least 8 times before I stopped getting blood, and when I checked internally the blood was definitely coming from near my cervix. Now I'm moderately cramping and worried. My strings feel fine.

I'll go in for a Pap and a checkup on Monday (since you're supposed to not have sex the day before a Pap, right?) since I haven't had a gyno exam in 3 years. But does anyone have any idea what might be going on? I'm a veterinarian and so I have a bad habit of assuming the worst medical causes for minor symptoms. My differentials are HPV, PID, uterine fibroids, slipping IUD, neoplasia... Ah!
Someone tell my overactive scientific imagination to settle down, please! Thanks folks!