Symptoms A-Z

8 Causes of Bleeding After Sex With & Without Pain

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.

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Noticing Blood After Sex? Your Symptoms Explained

The many variables surrounding sex make it so that it rarely means the same thing twice, but one thing is certain: bleeding after sex is something to take notice of. The underlying principle of sex is conception and bleeding is not an intended consequence. The female anatomy is designed to take steps towards preventing damage during sex that causes bleeding. If you see bleeding after sex, it is important to consider all symptoms and any possible causes [1,2].

Common characteristics of bleeding after sex

The following symptoms can be present:

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 [5,6].

What Causes Bleeding After Intercouse? 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. Common causes of bleeding after sex include:

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 [1,2].
  • Menstruation: Bleeding is typically a normal part of the menstrual cycle. Bleeding after sex may be associated with menstruation if sex occurred immediately before, during, or after a period.

Medical causes

Medical causes can be related to 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 and are examples of such diseases.
  • Tumors: Cancerous growths can damage the inner components of the vagina. Bleeding after sex can be an early warning sign of cervical cancer.

10 Possible Bleeding After Sex Conditions

The list below shows results from the use of our quiz by Buoy users who experienced bleeding after sex. This list does not constitute medical advice and may not accurately represent what you have.

Post-sex bleeding

Many women suffer from light bleeding after sex.

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

Cervical polyp

A cervical polyp is a growth that develops on the surface of the cervix. The cervix is the gynecological structure of the female reproductive system that connects the uterus to the vagina.

Symptoms are often absent with cervical polyps. However, in some cases, you may experience bleeding betw...

Endometrial polyp

Endometrial polyps are growths or masses that occur in the lining of the inner wall of the uterus and often grow large enough to extend into the uterine cavity. They attach to the uterine wall by a large base (these are called sessile polyps) or a thin stalk (these are called peduncul...

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

Atrophic vaginitis

Atrophic vaginitis is a common condition that may affect up to 47% of postmenopausal women. It occurs due to low levels of estrogen which can be caused by menopause, medical treatments, and hormonal conditions, among other things.

Symptoms of atrophic vaginitis include vaginal dry...

Bleeding After Sex Symptom Checker

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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

Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a hormonal condition very common in women of reproductive age, resulting in menstrual abnormalities as well as an excess of the androgen testosterone. PCOS can affect a woman's overall health and appearance and often has a si...

Chlamydia infection

Chlamydia trachomatis is a type of bacteria best known for causing the sexually transmitted infection known simply as chlamydia. It is among the most common sexually transmitted diseases (STDs), with more than a million cases reported each year in the U.S. alone.

However, the sy...

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

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

Treatments and Relief for Bleeding or Spotting After Sex

Bleeding after sex should be taken seriously, especially if atypical. There are times when the bleeding is minor and may subside without additional care; however, even small amounts of blood signal that it is time to consult your doctor [2].

When to see a doctor for bleeding after sex

In particular, contact your doctor if you experience any of the following:

Professional treatments

Treatments that can be recommended by your physician include the following.

  • Prescribed medications: Infections, including sexually transmitted diseases, are often fought treated by antibiotics prescribed by your doctor.
  • Outpatient procedures: Cauterization is sometimes used to stop bleeding associated with cervical or vaginal issues. This is an outpatient procedure used by a doctor to treat inflammatory issues and lesions [8].
  • Medical tests: Advanced testing of cells found in the vagina or cervix may be required if cervical cancer could be the cause of bleeding. If cervical cancer is diagnosed, a gynecologic oncologist will perform an evaluation and determine if chemotherapy, radiation, and/or surgery is required. Pre-cancerous cells are typically removed during an outpatient procedure.

At-home treatments and further advice

Reducing the amount of friction during sex can help limit bleeding. A variety of medications are also available over-the-counter to treat vaginal dryness and increase moisture [7].

The most important thing to remember is that bleeding after sex should not be accepted as normal and typical. Practicing safe sex and using lubrication during sex can be a helpful preventative measure, however, bleeding after sex may occur despite all best practices. Bleeding can be a sign of medical conditions that require attention from a doctor. Treatment is often readily available, and the cause of the bleeding can be remedied [2,6].

FAQs About Bleeding After Sex

Here are some frequently asked questions 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 intecourse 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, or believe you have, an STD then it is important to consult your doctor if you experience bleeding after sex [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 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 [10].

Questions Your Doctor May Ask About Bleeding After Sex

To diagnose this condition, your doctor would likely ask the following questions:

  • 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?

The above questions are also covered by our A.I. Health Assistant.

If you've answered yes to one or more of these questions

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Bleeding After Sex Symptom Checker Statistics

People who have experienced bleeding after sex have also experienced:

  • 18% Bloody Vaginal Discharge
  • 17% Vaginal Bleeding
  • 7% Vaginal Discharge

People who have experienced bleeding after sex were most often matched with:

  • 50% Cervical Polyp
  • 50% Endometrial Polyp

Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).

Bleeding After Sex Symptom Checker

Take a quiz to find out what might be causing your bleeding after sex

References

  1. What causes a woman to bleed after sex? NHS. Published March 27, 2018. NHS Link.
  2. Vaginal or uterine bleeding - overview. Mclaren Health Care. McLaren Link.
  3. Gynaecology & Women's Health. Reproductive Health Group. RHG Link.
  4. Symptoms Chlamydia. NHS. Published April 6, 2018. NHS.
  5. Does a woman always bleed when she has sex for the first time? NHS. Published Aug, 20, 2018. NHS.
  6. Why does sex hurt? NHS. Published May 11, 2018. NHS Link.
  7. Vaginal dryness. NHS. Published May 05, 2016. NHS Link.
  8. The American Cancer Society medical and editorial content team. Surgery for Cervical Cancer. American Cancer Society. Published December 5, 2016. ACS Link.
  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.

Disclaimer: The article does not replace an evaluation by a physician. Information on this page is provided as an information resource only, and is not to be used or relied on for any diagnostic or treatment purposes.