Doctors Explain 21 Reasons You Might Be Bleeding After Sex

Bleeding after sex as medically called post-coital bleeding. It is a kind of bleeding complaint that occurs after sex, and women mainly express it. It affects about 0.7 – 9.0% of women worldwide. 

Bleeding after sex is normal if:

  • This is your first sexual encounter 
  • You haven’t had coitus (sex) in a long time.

Other than the normal healthy reasons, bleeding after sex can be a symptom of other problems relating to the reproductive organs.

Major causes of bleeding after sex can be:

  1. Normal healthy Menstrual flow: it is always safe to have a period tracking app to track your period and know when the bleeding will start. Calculating menstruation free days is quite stressful for some women, while some women forget to mark their flow date on their calendar due to busy work-life schedules. So it is safe to download a period tracking app that will keep you up to date and remind you to take your sanitary product of choice with you, plan your sex life and prevent the shock and fear that comes after having sex, then seeing blood.
  2. Irregular menstrual flow: unexpected bleeding in between cycles can be considered as post-coital bleeding when the blood appears after sexual intercourse. Irregular periods can be caused by stress, polycystic ovarian syndrome (PCOS), or uterine fibroid. Check out this ways to relieve severe menstrual cramps.
  3. Vaginal laceration (tear, trauma): sexual intercourse requires the proper amount of vaginal lubrication to reduce friction during sexual intercourse. In the absence of adequate lubrication, any vigorous penetration done by the penis or any other items inserted into the vagina during sex can cause a slight tear to the vagina that could lead to bleeding. 
  4. Cervical Polyps: is a benign tumor on the surface of the cervical canal that can bleed when pressure is applied, for example, during intercourse.
  5. Vaginal Thrush: is a prevalent yeast infection that can cause bleeding. Here are the warning signs of thrush .
  6. Cervical Ectropion: is the outgrowth of cervical tissue that bleeds when pressure is applied to them during sex.
  7. Sexually transmitted diseases: namely gonorrhea, chlamydia, and trichomoniasis, one of the signs of STDs, is bleeding.
  8. Atrophic vaginitis: is tissue thinning due to low estrogen that leads to dryness of the vagina and itchiness. A dry vagina can lead to bleeding after sex
  9. Cervical cancer: post-coital bleeding can be an early warning sign of cervical cancer and require urgent medical checkups.
  10. Uterine fibroids: are smooth muscle tumors that occur in women of childbearing age.
  11. Normal uterine pregnancy: bleeding (spotting) in the earlier weeks of pregnancy is normal.
  12. Ectopic pregnancy: This is the implantation of the fertilized egg outside of the uterus. One of the earliest signs is bleeding.
  13. Pelvic inflammatory disease: It is the inflammation of the fallopian tubes, cervix, ovaries, and uterus that is usually caused by sexually transmitted infections.
  14. Endometriosisis the outgrowth of endometrial tissue into other tissues such as the ovaries, fallopian tubes, and other parts of the body.
  15. Endometrial polyps: are stalk-like growth in the inner lining of the uterus.
  16. Vaginal cancer: is a malignant tumor of the vagina.
  17. Polycystic ovarian syndrome (PCOS): is a hormonal disorder that causes multiple cyst formation in the ovaries. Check out these signs and symptoms of PCOS.
  18. Miscarriage (complete abortion): is the complete evacuation of the product of conception.
  19. Incomplete abortion: is the partial evacuation of the product of conception
  20. Contraceptives (oral or injection)
  21. Cervical intraepithelial neoplasia (CIN): is abnormal cell development in the cervix

Normal healthy bleeding after sex usually lasts for a period of 1-3 days, and it is usually not heavy bleeding. Post-coital bleeding may be accompanied by pain, itching, burning sensation, or vaginal dryness. 

Diagnosis

The diagnostic methods carried out in a woman with a post-coital bleeding aim at confirming the source of bleeding:

  • Pelvic examination
  • Pregnancy test
  • Pap smear
  • Ultrasound of the uterus
  • Colposcopy: is used to view the cervix, vagina, and vulva
  • Microscopic, culture, and sensitivity (M/C/S)

Treatment of post-coital bleeding

Normal post-coital bleeding usually stops in days, but in a case where there is a specific underlying cause, fast management of bleeding is commenced.

  • Heavy bleeding: will require vitamin K intake and fluid.
  • STDs: antibiotics are prescribed.
  • Cancer: chemotherapy, radiation therapy, or surgery is carried out.
  • Vaginal dryness: vaginal moisturizers, lubricants, and low dose estrogen therapy.
  • Cervical ectropion: cryotherapy or electrocautery
  • Polyps: Polypectomy.

Final Word: If you’re concerned about your vaginal bleeding after sex, seek guidance from your medical doctor for an accurate diagnosis.