Breakthrough Bleeding on Liletta IUD: Common and Expected

Bleeding Patterns with Levonorgestrel IUDs

Unscheduled spotting or light bleeding is expected and common during the first 3-6 months of LNG-IUD use, and generally decreases over time, according to the Centers for Disease Control and Prevention 1
This initial breakthrough bleeding is generally not harmful to health and decreases with continued use, as stated by the Centers for Disease Control and Prevention 1
Over time, bleeding generally decreases with LNG-IUD use, and many women experience only light menstrual bleeding or amenorrhea after extended use, as reported by the Centers for Disease Control and Prevention 1
Heavy or prolonged bleeding is uncommon during long-term LNG-IUD use, according to the Centers for Disease Control and Prevention 1

If breakthrough bleeding persists beyond the expected initial adjustment period, consider underlying gynecological problems, such as LNG-IUD displacement, sexually transmitted infections, or new pathologic uterine conditions, as recommended by the Centers for Disease Control and Prevention 1

Provide thorough pre-insertion counseling about expected bleeding changes to improve continuation rates, as suggested by the Centers for Disease Control and Prevention 1
Reassure patients that initial breakthrough bleeding is normal and typically improves over time, according to the Centers for Disease Control and Prevention 1
If bleeding persists beyond 3-6 months or suddenly worsens after a period of improvement, evaluate for underlying conditions, as recommended by the Centers for Disease Control and Prevention 1
Only consider removal if bleeding persists and the woman finds it unacceptable despite reassurance and treatment, as stated by the Centers for Disease Control and Prevention 1