Vaginal bleeding may occur after a long period of time with the ring, but contact bleeding is not usually present. Contact bleeding is often a sign of cervical lesions, such as cervicitis, cervical erosion, and cervical cancer, which are often not caused by IUDs but are more often associated with unclean sex, HPV infection, post-abortion infection, and other factors.
Some patients experience irregular vaginal bleeding after IUD, which is not contact bleeding and is often caused by damage to the endometrium and blood vessels from the IUD, as well as infections that occur after IUD placement.