According to a study published in Obstetrics and Gynecology International, up to 9% of women experience bleeding after sex. To determine whether you should see a doctor, it’s important to closely monitor your body’s signals.
In what cases is bleeding after sex normal?
It all depends on the amount and frequency of bleeding. According to OB/GYN Nicole Mahnert, a little bloody discharge that happens rarely or just once is normal. You may notice red spots on the bed, underwear, or between your legs. But if the bleeding is regular or painful, it’s best to see a doctor.
There are a few cases where bleeding does not indicate serious health problems.
Vaginal dryness
If you don’t have enough natural lubrication, friction during sex can damage sensitive vaginal tissue and cause bleeding. Sex can feel uncomfortable or painful, says OB/GYN Felice Gersh.
Vaginal dryness can be caused by:
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Hormonal changes. For example, due to low estrogen levels after childbirth , during breastfeeding, or during menopause . According to the gynecologic cancer organization The Eve Appeal, women who are premenopausal are more likely to experience bleeding after sex. In most cases, this is not a cause for concern, but if you experience bleeding frequently, it is best to seek medical attention.
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Insufficient arousal. If a woman is not aroused enough during sex, her natural lubrication may not be enough for comfortable penetration. Gynecologist Claire Bailey explains : Dryness at the entrance to the vagina causes tears, which bleed.
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Chemotherapy. It can damage the ovaries, causing them to no longer produce estrogen and progesterone. This leads to vaginal dryness.
Taking hormonal contraceptives
Spotting between periods or bleeding after sex could be caused by new hormonal contraception , says Nicole Mahnert . Some IUDs contain progesterone, which is slowly released over five years and keeps the lining of the uterus very thin. This can cause light bleeding after sex.
Usually, after a few months, the body gets used to it and the bleeding stops. However, this does not always happen, so if you notice that you often bleed after taking COCs or installing an IUD, see a doctor. He will help you choose alternative means of protection.
Rough sex
Rough movements during sex increase friction and can cause vaginal trauma, which can lead to bleeding. London Clinic therapist Pixie McKenna adds : trying new positions, having your partner pierce you intimately , or doing things you’re not used to can have the same effect.
Sex after a long break
Pixie McKenna explains that a single bleed after a long break is a normal variant. Most often, this occurs due to micro-tears in the vaginal tissue. The main thing is to make sure that the next time you have sex in the near future, it does not end in the same way. In this case, it is better to undergo an examination by a gynecologist.
When bleeding after sex is a reason to see a doctor
Sexually transmitted infections
Pixie McKenna claims that bleeding after sex can signal an STI , even if you haven’t noticed any other symptoms. According to Felici Gersh, most often, blood indicates an inflamed cervix due to infection, which can bleed due to friction. This can be caused by chlamydia, gonorrhea, trichomoniasis, and herpes. Therefore, if you had unprotected sex and noticed bleeding, it’s best not to delay an appointment with a gynecologist.
Inflammation of the pelvic organs
Often they appear due to undetected STIs. Sometimes, due to inflammation, bleeding and light bloody discharge appear not only after sex, but also right during it or between periods.
According to Pixie McKenna, pelvic inflammation is most often caused by chlamydia, and a little less often by gonorrhea, mycoplasma, ureaplasma and other diseases. In such cases, in addition to blood, a woman may be bothered by pain in the pelvic area, unusual discharge and its smell.
Polyps of the uterus and cervix
Polyps are growths that appear on the cervix or inside the uterus. According to Felici Gersh, polyps have many blood vessels feeding them. They are the ones that can bleed if they are touched during penetrative sex.
In the case of polyps, it is better to consult a doctor to find out why they appeared. Often, polyps are not treated in any way – they disappear on their own. But if the formations bother you, you may be offered medication or surgical removal.
Bacterial vaginosis
Bacterial vaginosis is a condition that changes the vaginal flora. Nicole Manert says that sometimes the disease causes inflammation and irritation, which leads to bleeding.
In addition to bleeding after sex, bacterial vaginosis may have the following symptoms:
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white or gray discharge;
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itching;
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unpleasant “fishy” smell in the discharge.
However, bleeding is not the most common symptom of bacterial vaginosis. Most people do not experience any symptoms.
Thrush with complications
According to Pixie McKenna, if the thrush was severe and also affected the vulva, but you continued to have sex, this can cause bleeding. The reason is trauma to the inflamed and irritated external genitalia. However, the specialist adds that this happens extremely rarely.
Uterine fibroids
Fibroids are benign tumors that form from the muscle tissue of the uterus. They usually grow on the wall of the uterus and can be as small as a pea or as large as a grapefruit. According to Filichi Gersh, the tumors can bleed during sex if they are located entirely or partially in the uterine cavity.
Cervical cancer
Cervical cancer is a cancer of the lower part of the uterus, which connects to the vagina. In the early stages, the disease may not bother women at all, according to the National Cancer Institute. But when the cancer spreads, bleeding is one of the main symptoms. During sex, the affected tissue becomes irritated. According to Filichi Gersh, the bleeding is usually painless and not very heavy.
Cervical ectropion
Ectropion is an eversion of the mucous membrane of the cervical canal. Sometimes the disease is also called cervical erosion, although this is considered outdated. Pixie McKenna explains the connection between bleeding and ectropion as follows: the mucous membrane of the cervix protrudes outward and becomes irritated due to contact with it. That is, if the partner touches the mucous membrane during penetration, blood may appear after or during se