Bleeding after sexual intercourse (medically known as postcoital bleeding) is bleeding that occurs during or immediately after intercourse, regardless of the menstrual cycle. According to research, approximately 0.7 to 9 percent of menstruating women experience this. It is often caused by harmless reasons; however, if it recurs, it must be evaluated.
Common and generally harmless causes
Vaginal dryness
It is one of the most common causes. Inadequate arousal, breastfeeding, menopause, certain medications, and hormonal changes can lead to dryness; friction may cause minor irritation and bleeding.
Cervical ectropion (a condition known as an erosion)
This is a condition where the sensitive cells on the inside of the cervix protrude outward. It is common in young women, pregnant women, and those taking birth control pills; it can bleed easily on contact and is generally harmless.
Polyps
Small benign growths in the cervix or uterus may bleed during intercourse; if necessary, they can be removed with a simple procedure.
First intercourse
There may be light bleeding during the first experience, or there may be none; both are normal. For more details, you can read our article on first-night anxiety.
Causes requiring treatment
- Infections: Sexually transmitted infections such as chlamydia and gonorrhea can cause inflammation of the cervix (cervicitis).
- Vaginal infections
- Endometriosis
- Cervical cancer and precancerous lesions: This is a rarer cause; however, recurrent bleeding due to this reason must be investigated. Regular smear tests are very important in this regard.
When should you see a doctor?
The NHS recommends that women who experience bleeding after intercourse or between periods consult a doctor or a sexual health clinic. Do not delay, especially in the following situations:
- If the bleeding recurs
- If the bleeding is heavy
- If it is accompanied by pain, fever, foul-smelling or unusual discharge
- If bleeding occurs after menopause
- If you are pregnant
- If your smear test is overdue
Your doctor will determine the cause through an examination, smear test, and, if necessary, infection tests or an ultrasound. Once the cause is found, treatment is usually straightforward.
Tips to prevent bleeding
- Take time for foreplay; arousal is important for natural lubrication.
- Use lubricant: Water-based lubricants reduce friction and irritation.
- Use a condom: It is the most effective way to protect against infections.
- Stop having sexual intercourse while the bleeding continues.
Sources
- NHS. Bleeding between periods or after sex. nhs.uk
- Cleveland Clinic. Bleeding After Sex: What It Means and When To See a Doctor. health.clevelandclinic.org
- Tarney CM, Han J. Postcoital bleeding: a review on etiology, diagnosis, and management. Obstetrics and Gynecology International. 2014;2014:192087.
This content is for general information purposes only; it is not a substitute for diagnosis and treatment. If you are experiencing bleeding, consult an obstetrician-gynecologist.
