Irregular menstrual bleeding among IUD users is not usually a sign of a health problem. Bleeding can, in fact, be a sign that the IUD is working properly. The copper released by the IUD interrupts the normal reproductive cycle and causes the endometrium to shed more frequently than during a woman's normal menses.
However, due to the possibility of increased bleeding with IUD use, women should be carefully screened for risk of anemia prior to insertion.
About 12% of women have the copper IUD removed because of increased menstrual bleeding or cramping. But after about 3 months of increased bleeding or spotting, the IUD reduces menstrual cramps and bleeding by an average of 90%.
In 1 out of 1,000 women, the IUD will get stuck in or puncture (perforate) the uterus, but that is rare and almost always happens on insertion.
*Although it sounds like the increased bleeding is a possibility, 20 days is a long time. Tell your doctor and see what he says.
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