Mannitol contains high potency progesterone, which can cause the endometrium to atrophy, and estrogen cannot maintain the integrity of the endometrium, so irregular vaginal bleeding occurs. This kind of bleeding does not belong to the category of dysmenorrhea.
Some patients experience irregular bleeding and spotting within 6 months after placing Mannitol, and most of them can be relieved after 6 months. This irregular bleeding is usually small and does not require special treatment. If the patient is very anxious and desperate for treatment, he or she can follow the doctor’s instructions and choose medication such as short-acting oral contraceptives, mifepristone, and nonsteroidal anti-inflammatory drugs.
It is also necessary to be alert to other causes of vaginal bleeding, such as cervical precancerous lesions or cervical cancer, which should be ruled out promptly.
If the bleeding is as heavy as the usual menstrual flow or more, it is important to review the ultrasound to find out whether the Mannix has shifted or dislodged.