Bleeding After Sex: Should I Be Worried?

Imagine you had a great time in bed but then are surprised to see blood. You can’t help but search online for answers. Bleeding after sex, also known as postcoital bleeding, can be concerning. But before you jump to the worst possible conclusions or diagnose yourself with a more serious or long-term issue, let’s understand what's normal, what's not, and when (and if) you should start worrying. 

First things first, is it normal to bleed after sex?

To answer in one word: No. But you need to understand that the human body is rather complex. While it’s not technically ‘normal’, it’s quite common to experience vaginal bleeding after sex due to various reasons. These reasons could range from dryness and friction to infections or cervical erosions. Cervical cancer can also result in post coital bleeding, but is NOT the only cause.

To put things in a clearer perspective, according to various studies, 0.7% to 9% of menstruating women experience vaginal bleeding after sex occasionally. So if you spot light bleeding after sex or find blood after intercourse on rare occasions, you’ve got nothing to worry about. But if you experience persistent and/or heavy bleeding post sex, especially if it’s accompanied by pain, you should check with your doctor.

Why am I bleeding after sex? 

It’s a fair question. So, let’s break down what might be happening behind the scenes to help you understand the cause of your symptoms.

Common causes:

• Menstruation
  Light bleeding after sex is common if you’re about to get your period or if it just ended.

• Vaginal dryness
  There could be various underlying factors for vaginal dryness, which can lead to friction and bleeding: 

• Intercourse before being fully aroused

• Genitourinary syndrome of menopause (GSM); vaginal skin gets dry, thin, and inflamed 

• Interaction with certain chemicals or medications

• Sjögren’s syndrome is an inflammatory disease that reduces moisture in the body

Causes demanding immediate attention:

• Infections
  Can trigger inflammation of the mucosa, leading to bleeding after sex. These infections include:

• Pelvic inflammatory disease (PID): It’s the infection of reproductive organs, including the fallopian tubes, ovaries, cervix, and uterus

• Sexually transmitted infections (STIs) like Chlamydia

• Cervicitis (inflammation of the cervix) or Vulvovaginitis (inflammation of the vulva and vagina)

• Cervical ectropion/erosions
  Often a harmless condition, caused when the inner lining of the cervix grows on the outside instead, leading to inflamed areas which cause bleeding and cramping after sex.

• Cervical polyps
  Small, noncancerous growths around the cervix or the endometrial lining. Their movement can irritate the tissues and cause blood after intercourse.

• Uterine prolapse
  May cause bleeding and cramping after sex as the uterus becomes saggy, dropping inside the vagina as the surrounding tissues weaken.
  

• Other causes 

• Hormonal changes or the use of certain medications 

• Trauma or tears to the vagina due to aggressive sex, childbirth, or any injury

The scariest and rarest cause:

• Cancer 
  While most cases of bleeding after sex are manageable, data states that 3% to 5.5% of women experiencing this symptom are identified with cervical cancer, while 6.8% to 17.8% were identified with precancerous conditions. The conditions may concern the cervix, vagina, or uterus. 

Light vs heavy bleeding after sex: What’s normal & what’s not

Let’s look at the differences between light and heavy bleeding after sex: 

How to avoid bleeding after sex?

Since various factors can lead to vaginal bleeding after sex, the way to tackle it completely depends on the cause. Here are some preventive measures you can follow:

• If your concern is dryness or friction, use a vaginal lubricant before and during sex to avoid friction. Use a vaginal moisturiser regularly to help increase moisture and restore the natural pH of the vagina. 

• Be slow and gentle during sex and stop if you feel any discomfort or pain. 

• Try to avoid sexual activity right before or after your periods. 

• Consider indulging in longer foreplay to avoid dryness. 

When to see a doctor?

Now that you have a deeper understanding regarding vaginal bleeding after sex, you know when to take action. Call your doctor if you experience: 

• Heavy or persistent post coital bleeding

• Bleeding at unusual times, especially after menopause

• Bleeding and cramping after sex accompanied by pain in the abdomen, pelvis, or lower back

• Symptoms that are related to a medical condition, be it infections or the risk of cancer

• If your gut says something’s off, listen to it and get it checked 

Myths about vaginal bleeding after sex

Often, the hushed conversations are way louder than the truth. So let us drop some truth bombs to bust all these widespread myths loudly and clearly. 

Myth 1: Bleeding after sex is totally normal.
Truth bomb: It’s common but not ‘normal’.

Myth 2: You must bleed the first time you have sex.
Truth bomb: Please understand, bleeding is not a reliable ‘virginity test’. Being super stretchy, the hymen may tear or not!

Myth 3: Bleeding means you have an STI or infection.
Truth bomb: Infections are indeed a leading cause of bleeding and cramping after sex, but you need to look at your symptoms more closely to conclude. 

Myth 4: If there’s blood, it’s probably cancer.
Truth bomb: While cancer is a common fear, it's actually very rare. As we said before, go catch up with your gynaecologist if you're in doubt.

Summing up

Bleeding after sex can be due to various causes and may leave one uncertain. But remember, you’re not alone. While some causes are very common and go away on their own, some causes, like cancer, require immediate medical attention. The best thing to do is seek medical attention as soon as you notice something unusual. Your doctor will guide you forward in the best possible way.

Frequently Asked Questions

1. Is it normal to bleed after sex?

It is not uncommon, but it’s technically never normal. If it is light bleeding after sex, stops and does not recur, it’s usually manageable. But heavy bleeding, which happens repeatedly, needs immediate medical attention. 

2. Can STDs cause vaginal bleeding after sex?

Yes, STDs can cause bleeding after sex due to inflammation, irritation, and weakened tissues. These diseases can include herpes, gonorrhea, and chlamydia.

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