Why I bleed after sex

The medical name for vaginal bleeding after sex is post-coital bleeding and there are many reasons why it can occur. Any woman of any age can experience it and, in fact, it’s quite a common occurrence. It is believed that most women will experience vaginal bleeding or spotting either during or after sex at least once in their life.

Mr Ashfaq Khan is a leading gynaecologist and obstetrician based in London, who has over 20 years of experience in dealing with this vaginal condition. He describes the more common and rarer causes of vaginal bleeding and when might be a good idea to see a specialist about it.

Is it normal to bleed after sex?

No. It is very important to consult a doctor if you notice bleeding either during and after sexual intercourse. However, a single episode of bleeding following intercourse before menopause may not be serious but should be carefully observed.

If you have already passed through menopause, then bleeding necessitates a visit to the doctor.

Why do I bleed after sex?

There are various reasons why you may bleed after sex. Most of the time, it is can be caused by one of the following:

• trauma, such as tears in the vagina caused by dryness or too much friction
• inflammation, which might be present due to cervical ectropion in which there is an inflamed area of the cervix
• an infection, such as pelvic inflammatory disease or an STI
• polyps, these are non-cancerous growths either in the womb or lining of the cervix

More suspicious causes could be pre-cancer or cancer of the cervix, vagina, or endometrium (lining of the womb). Rarely, auto-immune diseases like lichen sclerosis, Lichen Planus and psoriasis can cause such bleeding.

I’m bleeding after sex but it’s not painful: should I see a doctor?

Pain is not usually accompanied with post-coital bleeding. Most of the time, bleeding after intercourse without pain is more related to some pathology. It is important not to ignore bleeding after sex.

I’m bleeding after sex and it is painful: should I see a doctor?

Yes. Mainly for two reasons:

Firstly, if the bleeding is trauma-related than you may need to either repair the trauma or get treatment for it. Otherwise, the bleeding is very likely to continue.

Secondly, this condition can lead to dyspareunia (painful sex) and chronic pain which can significantly affect your sexual life.

I’m bleeding after sex and I’m pregnant: what does it mean?

It is not unusual to experience vaginal bleeding during pregnancy, but for many couples, it can cause significant distress. Though the risk of miscarriage or premature labour is not so common, it is strongly advised to see a doctor to exclude those causes.

Most of the time the source of bleeding is the cervix or vagina rather than from inside the womb. It is better to see a colposcopist (gynaecologist with colposcopy experience) who is more experienced to assess the cervix and vagina.

When should you see your gynaecologist about vaginal bleeding?

It is especially important to see a gynaecologist if there is any bleeding after menopause (over 50 years of age), during pregnancy or in anyone who has had a previous abnormal cervical smear result. Otherwise, if the bleeding is sporadic and minimal then you can wait for a couple of months to see if it clears up on its own.

That being said, it is always better to see a gynaecologist who is in a much better position to assess the condition and provide appropriate management.

If you experiencing any of the symptoms mentioned in this article, do not hesitate to contact Mr Khan by visiting his Top Doctors profile and booking a consultation.