Unusual Vaginal Bleeding Post-Coitus: Possible Causes and Remedies Discussed
Experience seeing red after the deed? That's postcoital bleeding for you. Here's the lowdown on why it happens and when it's a cause for concern.
Most of the time, it ain't nothing to worry about. But persistent bleeding after sex can hint at bigger issues, especially if it's a recurring problem.
Ob/Gyn Erin Higgins, MD, lays out the common culprits behind postcoital bleeding.
Why the bloody mess?
Did sex leave you with a bloody mess? You're probably wondering, What the hell is going on down there?
Vaginal bleeding is not the same as postcoital bleeding. The latter is linked to a variety of conditions that can be infectious or non-infectious.
"Infectious problems make us suspect genital tract infections," says Dr. Higgins. For non-infectious causes, doctors are concerned about vaginal atrophy, cervicitis, and other cervical issues.
Here are seven common causes of postcoital bleeding.
Menstruation
It may seem obvious, but first, let's rule out the time of the month. If you've recently had sex before or after your period, that might be the reason behind the bleeding.
Keeping track of your cycles with a menstrual calendar can help you resolve such questions and better understand what's happening during your menstrual cycle.
Vaginal atrophy or dryness
Also known as vaginal dryness, vaginal atrophy occurs when the skin of your vagina becomes dry and thin due to a lack of estrogen. It affects women of all ages, but it's more common after menopause.
If dryness is severe, the friction during sex might cause bleeding. Using lubrication before or during sex may help, but your doctor may recommend hormone replacement therapy if lubricants aren't sufficient.
Cervicitis
Cervicitis is inflammation of the cervix, often due to infections or irritation. Possible causes include STIs like chlamydia, gonorrhea, or trichomoniasis, bacterial vaginosis, or irritation caused by chemical substances such as spermicides, douches, or latex in condoms.
Although bacterial and viral infections can be contagious, cervicitis can be treated with antibiotics or antifungals.
Cervical ectropion
In cervical ectropion, the soft, glandular cells that line the inside of your cervical canal expand into the outer part of your cervix (where the cells are typically harder). This is a normal condition for many women and usually doesn't require treatment.
But if there are symptoms, such as excessive discharge or bleeding, it could require outpatient heat or cold therapy to treat the area and stop the bleeding.
Cervical polyps
These benign growths on the opening of your cervix can sometimes cause bleeding during intercourse. Minor symptoms may not require treatment. If your symptoms are more severe, your polyps may need to be removed and sent for evaluation to ensure they're benign.
Uterine prolapse
Uterine prolapse, which occurs when your uterus moves out of its normal position, is rare in younger women but tends to develop slowly over time. Symptoms may include bleeding. Your doctor can recommend weight loss, Kegel exercises, or surgery to repair the prolapse.
Cervical cancer
Postcoital bleeding can be a symptom of cervical cancer, especially if it's consistent. Most people with postcoital bleeding do not have cervical cancer, but it's essential to stay up-to-date with Pap and HPV screenings to help prevent it.
Is postcoital bleeding normal?
Any abnormal bleeding—be it a few drops or a significant amount—should be evaluated, states Dr. Higgins.
Light bleeding or spotting after sex can also occur if a fertilized egg implants itself along the lining of the uterus. Known as implantation bleeding, it can be one of the first signs of pregnancy. If your period is late and you notice bleeding after sex, take a pregnancy test.
When to see a doctor
Bleeding after sex is not automatically a sign of a severe problem. However, if it's consistent, you should see a healthcare professional to determine the underlying cause and receive appropriate treatment.
During your visit, your doctor will assess your medical history, ask about other irregular bleeding, heavy or irregular periods, unusual pain, changes in sexual partners, changes in vaginal discharge, when you had your last Pap test, and more. A physical exam will check for signs of infection. If your Pap test isn't current, your doctor can perform one for you during your visit.
Remember, most of the time, it's nothing serious. So, relax and get checked out if you're concerned. Your doctor will determine any necessary testing and help put your mind at ease.
- Postcoital bleeding can be a symptom of cervical cancer, especially if it's persistent, so it's crucial to stay up-to-date with Pap and HPV screenings to help prevent it.
- Cervical ectropion, a condition where the soft, glandular cells that line the inside of the cervical canal expand into the outer part of the cervix, can sometimes cause bleeding during intercourse.
- Cervicitis, inflammation of the cervix, can be a cause of postcoital bleeding, with possible causes including STIs, bacterial vaginosis, or irritation caused by chemical substances.
