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Causes of Bleeding After Sex

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Last updated April 16, 2024

Bleeding after sex quiz

Take a quiz to find out what's causing your bleeding after sex.

It is normal to bleed after sex if it your first time or if it has been awhile since your last sexual experience. However, if this is not the case, then bleeding after intercourse can be caused by trauma to the vagina, menstruation, a symptom of a sexually transmitted disease, or a cervical polyp. Read below for more information on causes and treatment options for bleeding after sex.

Bleeding after sex quiz

Take a quiz to find out what's causing your bleeding after sex.

Take bleeding after sex quiz

Noticing blood after sex? your symptoms explained

Sex rarely means the same thing twice, but one thing is for sure, bleeding after sex shouldn't go unnoticed. The female anatomy, in particular, is designed to withstand sex, with an underlying principle being conception. Bleeding may indicate damage to vital structures, and if you see blood after sex, consider all symptoms and any possible causes.

Common characteristics of bleeding after sex

The following symptoms can present with bleeding after sex:

Vaginal structure

The vagina is a complex structure extending from the vulva to the cervix. During sexual arousal, moisture is increased to facilitate smoother penetration during sexual activity. Vaginal bleeding after intercourse can be normal after you have sex for the first time, or if it has been a long time since your last sexual experience. Sometimes bleeding will stop and heal on its own, but it may also be a sign of more serious conditions.

What causes bleeding after intercourse? is it normal?

Bleeding after sex may be caused by direct trauma or from several illnesses. It is not uncommon for vaginal penetration during sex to irritate the vagina or cervix and cause bleeding. While the bleeding may appear to be directly associated with sex, there is also the possibility of other root causes.

Environmental causes

Environmental causes can be due to certain habits or natural bodily processes.

  • Trauma: The vagina is designed to increase moisture during sexual arousal to help reduce friction during intercourse. Without enough moisture, or if the penetration is too vigorous, friction could cause irritation to the cervix or vaginal tissue. The insertion of items into the vagina during sex may also cause bleeding.
  • Menstruation: Bleeding is typically a normal part of the menstrual cycle. Bleeding after sex may have to do with menstruation if sex occurred immediately before, during, or after a period.

Medical causes

Medical causes can involve underlying conditions or illnesses.

  • Infection: Infections, in the form of sexually transmitted diseases, can be passed between partners during sex. These infections can cause bleeding from the cervix to the fallopian tubes. Chlamydia, gonorrhea, and trichomoniasis are sometimes associated with bleeding after sex.
  • Tumors: Cancerous growths can damage the inner components of the vagina. Bleeding after sex can be an early warning sign of cervical cancer.

This list does not constitute medical advice and may not accurately represent what you have.

Uterine fibroids

Uterine fibroids are benign growths in the wall of the uterus and most often appear during childbearing years. Fibroids are almost never associated with cancer.

Those at higher risk include black women and women who started their periods at a young age. Other risk factors are vitamin D deficiency, poor diet, obesity, drinking alcohol, and family history of fibroids.

Fibroids can cause pelvic pressure and pain, severe menstrual cramping, and heavy menstrual bleeding that leads to anemia. Quality of life is diminished due to the chronic pain and discomfort. Though fibroids don't always make it impossible to become pregnant, infertility and pregnancy loss may occur as well as pre-term delivery.

Fibroids can be diagnosed through a routine pelvic exam or ultrasound in a doctor's office.

A gynecologist can prescribe various medications to ease the symptoms and regulate the menstrual cycle. There are also a number of surgical techniques, some minimally invasive, to shrink or remove the fibroids while leaving the uterus in place. Hysterectomy, or removal of the uterus, is an option in some cases.

Rarity: Common

Top Symptoms: vaginal bleeding, pelvis pain, abdominal cramps (stomach cramps), painful periods, irregular period

Urgency: Primary care doctor

Post-sex bleeding

Many women suffer from light bleeding after sex.

For now this is nothing to worry about. If your symptoms last longer than a month, make an appointment with your primary care physician or gynecologist.

Rarity: Common

Top Symptoms: bleeding after sex, vaginal discharge, urinary changes

Symptoms that always occur with post-sex bleeding: bleeding after sex

Symptoms that never occur with post-sex bleeding: urinary changes, vaginal discharge, vaginal pain

Urgency: Wait and watch

Polycystic ovary syndrome

Polycystic ovary syndrome, or PCOS, is a condition in which a woman's ovaries do not correctly release one egg cell per month (ovulate) as is normal. Instead, the egg cells remain on the surface of the ovary and fluid-filled cysts form around them.

The cause is not entirely known, but PCOS can be caused by significant weight gain because that brings about hormonal imbalance and insulin resistance. There may also be hereditary factors.

Symptoms include very irregular and abnormal menstrual periods. There may be signs of excess male hormones such as acne, facial and body hair, or even male pattern baldness.

Untreated PCOS can lead to infertility, complications of pregnancy, abnormal uterine bleeding, depression, and endometrial cancer.

Diagnosis is made through symptoms, pelvic examination, blood tests, and ultrasound.

PCOS is often treated with birth control pills, which suppress ovulation, regulate the monthly cycle, and decrease male hormone production. Maintaining normal body weight can often help the condition.

Pelvic inflammatory disease

Pelvic inflammatory disease, or PID, is the general term for a bacterial infection of a woman's reproductive organs.

PID is most often a complication of a sexually transmitted disease (STD) such as gonorrhea or chlamydia. However, it is possible to get PID from other causes.

Any woman can be affected. It is most often found in sexually active women under age 25, especially those who have had PID before, have multiple partners, and/or douche frequently.

Symptoms include fever, lower abdominal pain, foul-smelling vaginal discharge, pain and/or bleeding during sex, and pain on urination.

Untreated PID can cause infertility due to damaged tissue in the reproductive tract, as well as chronic pelvic and abdominal pain. Unprotected sex partners will be infected as well.

Diagnosis is made through symptoms, pelvic examination, vaginal and cervical swabs, and urine tests.

Treatment is with a course of antibiotics. Be sure to finish all of the medication as directed, even when you begin feeling better.

To prevent PID, have all partners (male or female) tested for STDs and avoid unprotected sexual contact.

Rarity: Common

Top Symptoms: fever, abdominal pain or unusual vaginal discharge, vaginal discharge, nausea or vomiting, vaginal bleeding, pelvis pain

Symptoms that always occur with pelvic inflammatory disease: fever, abdominal pain or unusual vaginal discharge

Urgency: In-person visit

Gonococcal cervicitis

Gonococcal cervicitis is an inflammation of the cervix – the passageway at the lower end of the uterus – caused by the bacteria Neisseria gonorrhoeae, or gonorrhea.

Gonorrhea is a sexually transmitted disease (STD) and spreads through unprotected sexual contact.

Symptoms include abnormal vaginal discharge, pain or discomfort during sex, and vaginal bleeding after sex. However, some women have few or no symptoms.

If not treated, gonococcal cervicitis can lead to further infection of the reproductive tract and to pelvic inflammatory disease, which can cause sterility.

Diagnosis is made after a cervical swab is taken and tested.

Treatment is through a course of oral antibiotics. Women diagnosed with gonococcal cervicitis should be further tested for other common STDs such as chlamydia and trichomoniasis, as they are often found at the same time.

The best prevention for gonorrhea is the use of a condom during sex, as well as testing of all sex partners so that they can be treated and not re-infect anyone.

Cervicitis in general can be prevented by not exposing the cervix to douching or other irritants.

Rarity: Uncommon

Top Symptoms: vaginal discharge, vaginal bleeding, painful sex, yellow pus vaginal discharge, heavy menstrual flow

Symptoms that never occur with gonococcal cervicitis: improving vaginal discharge

Urgency: Primary care doctor

Endometrial polyp

Endometrial polyps are noncancerous growths in the uterine cavity. Associated symptoms include spotting and bleeding during or after sexual intercourse.

You should speak with your primary care physician or OB/GYN about these symptoms.

Chlamydia infection

Chlamydia is a common bacterial infection that is spread through unprotected sex. Each year, over 1 million Americans are diagnosed with this STD.

You should visit a physician to confirm the diagnosis where an antibiotic will be prescribed.

Cervical polyp

Cervical polyps are noncancerous growths in the cervical canal. Associated symptoms include spotting and bleeding during or after sexual intercourse.

You should speak with your primary care physician or OB/GYN about these symptoms.

Atrophic vaginitis

Atrophic vaginitis is a condition causing dryness of the vagina. It is caused by a drop in estrogen levels, which happens due to menopause, stress, medication side effects, and childbirth. Other symptoms include painful sex and vaginal soreness.

You should consider visiting a medical professional to discuss your symptoms. Atrophic vaginitis is evaluated with a review of your symptoms and a pelvic exam. Once diagnosed, it can be treated with estrogen replacement, moisturizers, and lubricants. Avoiding douching and perfumes may help dryness from worsening.

Symptoms of menopause

Menopause is the name for the natural process by which the menstrual cycle (period) stops happening in a woman. Usually, the process is gradual (takes months or years) and occurs from the age of 45 to 55 years. Menopause is officially diagnosed once a woman stops having a period for 12 months continuously. A woman with menopause will notice a decrease in the number and regularity of her periods until they completely stop. In addition, she may notice a number of symptoms that occur as a result of decreased estrogen levels, such as hot flashes, changes in mood, sleep problems, vaginal dryness, changes in libido, and changes in sexual function. Certain medications exist that can decrease these symptoms.

Rarity: Common

Top Symptoms: fatigue, delay in or irregular periods, vaginal discharge, anxiety, trouble sleeping

Symptoms that always occur with symptoms of menopause: delay in or irregular periods

Urgency: Self-treatment

Treatments and relief for bleeding or spotting after sex

When to see a doctor

See your doctor if you experience any of the following.

  • Heavy flow of blood
  • Pain associated with bleeding: Either during or after sex
  • Bleeding that occurs several days after sex

Medical treatments

Your physician may recommend the following treatments.

  • Prescribed medications: Infections, including sexually transmitted diseases, often require antibiotics.
  • Outpatient procedures: Cauterization is sometimes used to stop bleeding associated with cervical or vaginal issues. This procedure is outpatient and helps treat inflammatory issues and lesions.
  • Medical tests: If cervical cancer is a potential cause, advanced testing of cells from the vagina or cervix may be necessary. If you receive a diagnosis of cervical cancer, a gynecologic oncologist will evaluate you and determine if your case requires chemotherapy, radiation, or surgery. Pre-cancerous cells are typically removed during an outpatient procedure.

At-home treatments and further advice

Try to reduce the amount of friction during sex to limit bleeding. A variety of medications are also available over-the-counter to treat vaginal dryness and increase moisture. Remember you should not accept bleeding after sex as normal. Practice safe sex and use lubrication; however, bleeding after sex may occur despite all best practices. Bleeding can be a sign of medical conditions that require attention from a doctor.

Here are some over-the-counter (OTC) options that can help manage symptoms and indications for when it might be necessary to consult with a doctor:

Vaginal Lubricants: To reduce friction during intercourse and minimize the risk of bleeding, consider using a water-based lubricant.

Vaginal Moisturizers: Regular use can help maintain vaginal moisture and elasticity, reducing discomfort during sex.

FAQs about bleeding after sex

How long can you bleed after intercourse?

The duration of bleeding after intercourse varies. Light bleeding may occur for several hours or for as long as a day, particularly if it is your first time having sex. You should contact your doctor if you experience any bleeding after sex. Bleeding for long durations of time should be examined more urgently.

Can bleeding after intercourse be a sign of early pregnancy?

It is not unusual for some minor bleeding after intercourse to occur during early pregnancy. Spotting, in general, is common during the first trimester, and sex can often be a trigger. Always tell your doctor about spotting or bleeding after sex if you are or believe to be pregnant. Bleeding during pregnancy may not always be a problem, but it should be checked by a medical professional.

Do STDs cause bleeding after sex?

Vaginal bleeding is a symptom of several STDs. Having sex while having an STD can sometimes trigger the bleeding. People with HPV, chlamydia, and gonorrhea have been known to exhibit vaginal bleeding as a symptom. If you are sexually active and have an STD, or believe you have an STD, consult your doctor [9].

Is my vaginal dryness leading to bleeding after sex?

During times of sexual arousal, the vagina increases moisture. If the vagina does not produce additional moisture or is dry, penetration during sex can cause excessive friction. This friction may damage the cervix or vaginal tissue and lead to bleeding during or after sex.

Is bleeding after sex an IUD side effect?

Typically, an IUD in it of itself is not a cause for bleeding after sex. The insertion of an IUD may cause spotting that may present itself after sex for 36 months after placement, however. Infections are also a common side effect of IUD insertion. If not properly treated, an infection may lead to bleeding.

Questions your doctor may ask about bleeding after sex

  • Do you use birth control beside condoms?
  • Do you feel pain when you have sexual intercourse?
  • When was your last menstrual period?
  • Do you feel pain when you urinate?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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The stories shared below are not written by Buoy employees. Buoy does not endorse any of the information in these stories. Whenever you have questions or concerns about a medical condition, you should always contact your doctor or a healthcare provider.
Dr. Rothschild has been a faculty member at Brigham and Women’s Hospital where he is an Associate Professor of Medicine at Harvard Medical School. He currently practices as a hospitalist at Newton Wellesley Hospital. In 1978, Dr. Rothschild received his MD at the Medical College of Wisconsin and trained in internal medicine followed by a fellowship in critical care medicine. He also received an MP...
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  1. What causes a woman to bleed after sex? NHS. Published March 27, 2018. NHS Link.
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  6. Why does sex hurt? NHS. Published May 11, 2018. NHS Link.
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  9. Sexually transmitted infections (STIs). NHS. Published Sept, 04, 2018. NHS Link.
  10. Dahlberg, BrunoKullander, StigForsgren, Arne et al. Bacterial infection in relation to pain and irregular bleeding in women using IUD. Contraception , Volume 20 , Issue 1 , 71 - 75. Published Jul, 1979. PubMed.