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Irregular spotting with a Copper IUD

Hello,

I have had the 5 year Mona Lisa copper IUD for about a year and a half with relatively steady spotting between periods. Initially it was much worse and would come with cramping and spotting for about a week, a few times it seemed like it was clumpy spotting.

I went to a doctor around the one year mark and they did a number of STI tests and other possible infections, a pap test and an ultrasound. I was told everything came out normal and my ultrasound revealed the IUD was in its correct place. The doctor said they could not figure out what was causing the spotting and was not very helpful in suggesting what I can do to determine what was going on.

Since then I've been tracking what activities I take part in when the cramping and spotting occurs, and it generally but not always occurs after having sex. Sometimes it happens when I work out, and other times I cannot pinpoint why it begins. I have recently had my first month where I experienced no spotting at all, so I am hopeful it is just my body adapting to the foreign object.

I would prefer to keep the IUD in if at all possible, but wanted to know if I should continue to seek additional medical help or just wait a while longer and hope it goes away. Does this have a potential to affect the health of my uterus in the future? Is there a chance it could be shifting around during sex and injuring my uterine lining and can it impact my ability to become pregnant in the future?
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