It is not uncommon to bleed after intercourse. It can happen for many reasons, such as vaginal dryness, an injury, or polyps. Bleeding can also indicate a more serious condition, however, such as endometriosis or cancer.
Postcoital bleeding refers to genital bleeding after intercourse. The medical community typically uses this term to describe bleeding from the vagina
A small number of those who menstruate may experience bleeding after sex. The source of this bleeding tends to be more varied in those who are no longer menstruating.
An estimated
Injury
The friction and abrasion of intercourse can cause small tears and cuts in sensitive genital tissues. Childbirth can also cause vaginal tissues to stretch and tear, sometimes making them more vulnerable to injury.
On the first occurrence of sexual intercourse, a small flap of vaginal skin called the hymen is often stretched and broken. This can cause minor bleeding. While some people experience bleeding and pain, others do not.
Vaginal dryness
Vaginal dryness is another cause of postcoital bleeding. When the skin is dry, it becomes extremely vulnerable to damage. Mucus-producing tissues, such as those in the vagina, are especially vulnerable.
Common causes of vaginal dryness include:
- going through menopause as it can cause vaginal atrophy
- having had a hysterectomy
- childbirth and nursing
- medications, such as contraceptive pills or antidepressants
- engaging in intercourse before arousal
- using perfumed soaps or washes in and around the vagina
- vaginal douching
Infections
Any type of infection can cause inflammation of vaginal tissues, making them more vulnerable to damage. These can include:
Cervical or endometrial polyps or fibroids
Polyps and fibroids are tiny noncancerous growths. They commonly grow on the lining of the cervix or uterus and can cause irregular bleeding.
Cervical ectropion
Glandular cells from the inside of the cervical canal can abnormally grow on the outside of the cervix. This condition is called cervical ectropion and usually clears up without treatment, but it can cause spotting and vaginal bleeding.
Endometriosis
Endometriosis causes endometrial tissues, the tissues that line the uterus, to grow outside of the uterus. This can cause inflammation, usually in the pelvic region and lower abdomen.
Cervical dysplasia
Cervical dysplasia occurs when abnormal, precancerous cells grow in the lining of the cervical canal, which is the opening separating the vagina and uterus. These growths can irritate and eventually damage surrounding tissues, especially during intercourse.
Postcoital bleeding
Anatomical abnormalities
Some people have differently shaped reproductive organs, which may increase the likelihood of painful friction and tearing.
Cancers
Cancers that impact the reproductive system or urogenital tract can alter vaginal tissues and hormone levels, making them more vulnerable to damage. Postcoital bleeding can be a sign of both cervical and uterine cancers.
A person can speak with a doctor any time postcoital bleeding is severe, frequent, or continues for more than a few hours after intercourse.
It is also important to speak with a doctor if postcoital bleeding is accompanied by additional symptoms, including:
- vaginal burning or itching
- abnormal discharge
- intense abdominal pain
- nausea, vomiting, or lack of appetite
- stinging or burning when urinating
- stinging or burning during intercourse
- lower back pain
- unexplained fatigue and weakness
- headaches or lightheadedness
- abnormally pale skin
- bladder or bowel symptoms
There are no national or international guidelines doctors use to diagnose or manage postcoital bleeding. Many medical professionals will ask questions about individual and family medical histories and perform a full physical exam.
Additional tests may include:
- culture tests for infection
- biopsies of abnormal growths and masses
- a colposcopy
- a transvaginal ultrasound
- an endometrial biopsy
- blood tests and a pregnancy test may also be necessary
If a doctor can not determine the cause of problematic bleeding, they may refer a person to a gynecologist.
In many cases, there is no single clear cause of postcoital bleeding, so there is no direct course of treatment.
Potential treatment options include:
- vaginal moisturizers
- antibiotics for infections caused by bacteria, such as gonorrhea, syphilis, and chlamydia
- medications for viral infections
- surgical removal, cryotherapy, or electrocautery in cases of cervical ectropion
- removal of polyps, especially those that cause significant bleeding or appear abnormal
- surgery or therapy for cancer
- low dose vaginal estrogen therapy, in the form of creams, suppositories, or rings, for vaginal dryness
Minor postcoital bleeding can often not be prevented. However, the following actions may help to prevent it:
- staying hydrated
- using water- or silicon-based lubricants during foreplay and intercourse.
- avoiding aggressive sexual acts
- using vaginal moisturizers on a daily basis
- avoiding scented or flavored feminine products
- always using condoms, especially when engaging with different sexual partners
- talking with sexual partners about anxieties and reluctance surrounding intercourse
- trying to become aroused before engaging in intercourse
- seeking medical advice and treatment for suspected infections
- using natural remedies that have been scientifically shown to help reduce vaginal dryness
No, having sex does not induce a person’s period. However, a person may experience bleeding after sex unrelated to their menstrual cycle. This may be due to an infection, the friction of intercourse, or vaginal dryness.
Pregnancy, childbirth, and nursing all cause significant hormonal changes that can make vaginal tissues more prone to damage. During pregnancy, minor bleeding during or after intercourse is not uncommon.
A person can speak with a doctor about any form of heavy or prolonged bleeding during early pregnancy. Seek immediate medical care for bleeding during the late pregnancy, as it can be a sign of preterm labor.
Bleeding after sexual intercourse is a common occurrence. Postcoital bleeding normally stops on its own. However, severe, chronic, or complicated cases require medical attention.
People who experience postcoital bleeding during periods of hormonal changes, such as menopause, pregnancy, or breast-feeding, should also talk with a doctor.