Bleeding After Sex
Yikes! Bleeding after sex can be a terrifying experience, but can often be attributed to one of the causes below. So don’t panic. (Well you’re allowed to panic, but just read this first).
Pain or Burning After Sex
Is there pain/discomfort, or does it burn when you urinate after sex? This could be a sign that you have developed micro-tears at the vaginal opening (introitus) due to lack of lubrication. These typically heal very quickly on their own and do not require medical intervention. But they can be uncomfortable in the short term and are a frequent cause of bleeding. This is easily avoided with use of gentle lubricant right at the vaginal opening and some on your partner.
If you have used ridiculous amounts of lubricant and still experience pain and/or bleeding with sex, it’s time to head to your sexual health provider for a more thorough exam and possible testing.
Vaginal Infections
Is there anything else that you’ve noticed besides bleeding? Is there change in the color or odor of your vaginal discharge, or are you itchy inside or out? These can be signs of a vaginal infection, or a sexually transmitted infection. Even simple vaginal infections, like yeast and bacteria, can cause lots of inflammation that results in bleeding with sex. These types of infections, along with sexually transmitted infections like chlamydia and gonorrhea, have to be tested for in a providers office. All of these infections are curable with simple medication, but it typically requires a prescription.
Structural Causes
There are anatomical reasons why you could experience bleeding with sex.
Polyps are very common. They are a simple overgrowth of soft tissue and are typically benign. Sometimes we can see them right at the cervix when we insert a speculum, and sometimes they are inside the uterus. If you have a completely normal exam in the office, your provider might recommend a pelvic ultrasound to rule out polyps. Wherever a polyp is located, it can cause irregular bleeding, and bleeding with sex. The good news is that they are typically easily removed in an office setting and do not require a trip to the operating room.
Cervical Ectropion is another common cause of bleeding. A young, healthy person typically has prominent ectropion on their cervix. This is a type of cell that bleeds easily, which can cause bleeding with sex. It is diagnosed just by visualizing the cervix on exam, and there is no intervention or medication that can be taken to resolve ectropion. It’s one of those annoying situations that are normal, but can cause symptoms for you.
Lastly, the color of bleeding doesn’t indicate anything dangerous. If it is bright red, or dark brown, it doesn’t really matter too much. Your provider will want to know how much, and for how long it lasts after sex.
SIDE NOTE: What if you’re a male partner reading this, why do you care and what should you say? It’s not an easy subject to bring up, and I wouldn’t recommend jumping to, “Hey, you need to go get yourself tested.” But some better options would be:
“I really care about you and it makes me worried that you’re bleeding.”
“I just want you to make sure you’re okay. Maybe you should see your doctor just to be safe?”
Bleeding after sex can be scary, but a simple evaluation by your healthcare provider can put your mind at ease that you’re not dying, and that nothing is going to fall out.
