What is the reason for bleeding after coitus 15 days after medication abortion?

Patient's question:

I met a handsome guy a while ago, and later we got together romantically. We ended up having a sexual relationship, but during our first time, we didn't take precautions, and she got pregnant. After that, following the doctor's advice, she had a medication abortion. After the abortion, 15 days later, she had a little bit of bleeding again. What could be the reason for this?

Doctor's answer:

Hello. In general, medication abortion may lead to incomplete expulsion, which might necessitate a follow-up procedure called a D&C (dilation and curettage). The D&C can cause further damage to the endometrium, so sexual activity should be avoided for at least one month. However, if you engaged in sexual activity after only 15 days, this could be due to intense activity, which may have reopened an incomplete scar, leading to bleeding again. This situation also increases the risk of infection and inflammation, so it’s important to be cautious. It’s best to visit a hospital for a check-up and follow the doctor’s advice regarding medication.

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