My girlfriend and I had sex (I am a female)

Patient: My girlfriend and I had sex (I am a female) with no penetration and I still am experience spotting and some tissue shedding. I do have an IUD and have had one for at least 3 years due to heavy, painful periods. Why would I be experiencing this with no penetration?

Symptoms: Spotting, tissue shedding vaginally

Doctor:

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