Is it permissible for a woman who has had an IUD inserted for health reasons and sometimes experiences spotting because of it to perform Umrah?

It is permissible for a woman to enter into ihram for Umrah or Hajj while menstruating. This also applies to a woman who anticipates menstruation or the discharge of blood that might be istihadah (post-menstrual bleeding). This is supported by the Prophet's instruction to Asma bint Umays, upon her postpartum bleeding, to perform ghusl, tie her lower garments, and enter into ihram. If a woman enters into ihram and then her menses begin, there is no harm upon her, but she is prohibited from circumambulating the Kabah until she purifies herself, as narrated in the hadith of Aishah. She must ascertain whether the blood is menstrual blood or istihadah by distinguishing its color and odor, or by its discharge during her usual days of menstruation.