Why do women bleed after sex and how dangerous is it?

March 11, 2024 Abdullah Arif

Bleeding after sex not related to menstruation is a common problem. About 9% of women experience it . Discharge may occur after penetration, including with toys or fingers.

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When to see a gynecologist

If you only notice blood once and it’s a small amount, you’re probably fine. Such situations happen, but most often do not pose a threat to health. However, you should consult a gynecologist if :

The bleeding doesn’t stop.
You think there is a risk of contracting a sexually transmitted infection, but there are no signs yet.
There are symptoms of STIs: itching, burning, rash and redness in the perineal area.
There is other vaginal discharge other than blood. For example, curds or copious mucus.
Bleeding from the vagina after sex has become regular.
There is a lot of blood – more than a few drops.
You feel nauseous or even vomiting.
You have noticeable pain in your lower back and lower abdomen.
Bleeding, even small, occurs in postmenopause – that is, after your period has finally ended.

Call 103 or 112 if heavy bleeding after sex occurs during pregnancy.

The doctor will conduct an examination and give directions for research. For example, a blood test or ultrasound. Based on the results, the gynecologist will make a diagnosis. Depending on it, you will be prescribed treatment, which will also solve the problem of bleeding.

Perhaps a specialist will recommend giving up sex while you recover your health. This is a common recommendation, for example, if the patient has an STI.

Why does blood occur after sex?

There may be several options.

Vaginal dryness

This is a long-term condition in which the vaginal lining becomes drier and thinner. Most often, this is caused by a lack of the female hormone estrogen . It is also responsible for the elasticity of vaginal tissue and the production of lubrication.

Estrogen levels can drop for many reasons :

childbirth and breastfeeding;
smoking;
menopause and the period of body restructuring before it;
immune disorders;
taking anti-estrogenic medications;
chemotherapy and radiation therapy for cancer that impairs ovarian function;
removal of ovaries.

Sometimes vaginal dryness can be caused by causes unrelated to estrogen levels. For example, douching frequently and taking certain cold or allergy medications.

Dryness can also be one of the causes of vaginal microtrauma.

Vaginal microtraumas

Small tears can appear not only due to lack of lubrication and changing estrogen levels. The cause is too intense sexual intercourse. And also – the lack of foreplay before sex. In this case, the woman simply does not have enough time to warm up. The result is that the penis rubs the thin mucous membrane until it bleeds.

Also, microtraumas can be caused by something unusual – for example, an incorrectly installed intrauterine device or piercing on the partner’s genitals .

STI

There are more than 20 types of sexually transmitted infections. They can cause pain during sex and slight bleeding afterwards. For example, blood flows with trichomoniasis, which appears due to a single-celled parasite, or syphilis and genital herpes, which cause ulcers outside and inside the vagina.

But, as a rule, infections make themselves felt even without connection with sex. They are accompanied by itching, burning, unusual discharge, pain when urinating , rash or warts in the perineal area.

Vaginitis

This is the general name for inflammation of the vagina. Vaginitis can be caused by infection, douching, poor hygiene, inappropriate cleaning products, or the use of rough toilet paper.

Uterine prolapse

This condition is also called prolapse. It occurs when the muscles and ligaments of the pelvic floor become stretched and weakened. Because of this, the uterus does not receive sufficient support and “slips out” into the vagina. As a result, bleeding may occur during sex . This often happens after childbirth.

It is believed that as long as this condition does not cause discomfort, it is not necessary to treat it.

Myoma

This is a common type of non-cancerous tumor – a growth of muscle and tissue that can occur both on the surface of the uterus and inside it.

A woman may develop one fibroid or several at once. These formations can be very small or the size of a grapefruit. A large tumor can distort the inside and outside of the uterus.

Fibroids often cause no symptoms, and many women don’t even know they have the problem. But sometimes characteristic signs may still appear :

heavy, prolonged or painful periods;
pressure or pain in the pelvic area;
frequent or too infrequent painful urination;
enlarged belly;
constipation;
pain in the abdomen or lower back;
bleedingafter sex.

Endometriosis

This is a condition in which the endometrium grows and extends beyond the uterus.

Endometriosis can make itself felt by a couple of drops of blood appearing after sex, as well as heavy bleeding during menstruation and spotting between them.

Cervical erosion

The cervix is the narrow lower part of the organ that connects it to the vagina. When erosion occurs , the cells that normally line the inside of the cervix protrude outward. Because of this, tissues can be damaged, displaced, have ulcers or other defects, and bleed slightly immediately after rough sex.

This is a harmless condition that usually does not require treatment unless there is excessive vaginal discharge or heavy bleeding.

Cervical polyps

This is the name for benign formations on the cervix, but they can also develop on the uterus itself. Polyps are most often encountered by women aged 40 to 50 years who have had multiple pregnancies.

Polyps are not dangerous, but can cause problems with conception , light bleeding after sex, between periods and after menopause.

If you suspect that you have such formations, you need to contact a gynecologist: the doctor will conduct a diagnosis and find out whether there is a possibility of malignancy. Polyps sometimes disappear without treatment, but in some cases surgical removal may be necessary.

Pregnancy

In most cases, bleeding after sex during pregnancy is normal . They arise due to the fact that superficial veins and capillaries enlarge in the area of the cervix and vagina. They get damaged during sex. These are harmless injuries that resolve quickly.

But when there is a lot of blood, this can indicate serious problems : placental previa or placental abruption and ectopic pregnancy.

Cancer

Oncological processes sometimes manifest themselves as bleeding after sex :

cancer of the fallopian tubes or ovaries;
leukemia – blood cancer;
adrenal tumors;
oncological diseases that do not affect the genital tract: colorectal cancer and bladder tumors.

How to prevent bleeding after sex

If your situation does not require seeing a doctor, you can try to prevent minor bleeding on your own. For this:

Avoid rough sex.
Spend more time on foreplay.
If you feel dry, use lubricant.
Try changingyour position. For example, the missionary position can put extra stress on the vagina and cause pain. But the side position will probably be more comfortable.
Monitor your menstrual cycle and wait a few days after your period ends before having sex.
Get regular screenings to screen for cancer and other possible diseases.