Bleeding after intercourse

Proven content

Bleeding after intercourse, and proper any vaginal bleeding occurring outside the period of menstruation should be diagnosed in the gynecologist’s office. It proves that there are structural or functional abnormalities (most often associated with hormonal disorders) of the reproductive system.

Bleeding after intercourse

This type of bleeding can take various forms, so very often patients are not able to determine whether the bleeding is directly related to sex. The bleeding may be slight spotting, clearly visible bleeding, or brown-colored mucus. There is one rule – do not ignore such symptoms, because bleeding after intercourse, and in fact any vaginal bleeding, is a cause for concern. The patient should make an appointment for a gynecologist immediately, even if vaginal discharge occurs after intercourse.

What are the causes of bleeding after intercourse?

Bleeding that appears once after the first sexual intercourse is usually associated with a rupture in the hymen. It occurs especially in girls whose membrane is thicker, less flexible or almost completely obstructs the entrance to the vagina. In many young women, the hymen is very thin, virtually invisible, and its ‘tearing’ does not cause any symptoms or slight spotting.

If you experience bleeding after intercourse, don’t panic and make a diagnosis yourself. It does not always mean the worst – cancer. There are many causes of vaginal bleeding.

Bleeding after sexual intercourse, also known as contact bleeding, can occur because of:

1. minor injuries during penetration (postmenopausal women are more prone to such injuries due to atrophic changes in the mucosa, vaginal dryness, etc.)
2. the so-called erosion located on the cervical disc
3. benign neoplastic lesions such as polyps
4. malignant neoplastic lesions of the vagina (rare) and cervix (common)
5. anatomical defects of the vagina that make intercourse difficult, e.g. transverse or longitudinal partitions of the vagina (the leading symptom is pain during intercourse).

Medical conditions that cause bleeding after intercourse include:

1. prolapse of the pelvic organs – mainly affects the bladder, cervix or rectum; this type of ailment most often affects obese women in old age who suffer from constipation or have had their uterus removed. If part of the uterus or the entire uterus passes through the vagina, it causes irritation or trauma during sex, which results in bleeding;
2. vaginal mucosa atrophy – usually occurs in elderly women after menopause, who have very low estrogen levels. Atrophy is characterized by dryness, burning sensation and painful intercourse in the vagina. Atrophy (atrophy of the vaginal mucosa) is an excellent basis for various micro-injuries during sex and emerging bleeding;
3. endometriosis;
4. vascular tumors (benign) – are a rare cause of bleeding after sexual intercourse. The condition includes hemangiomas and various types of arteriovenous malformations, the damage of which during sex causes bleeding.

Other causes of bleeding after intercourse:

1. the presence of foreign bodies in the vagina, damaging even the cervix;
2. rape or sexual violence (often apart from damaging the vagina itself, the perineum is torn).

Bleeding or spotting between menstrual periods or after intercourse can also occur during sex using hormonal contraception. Purulent vaginal discharge stained with blood indicates bacterial inflammation of the genital tract (e.g. gonorrhea, chlamydia, BV). It is not uncommon that bleeding after intercourse occurs as a result of too hard sex. This is when the bleeding occurs because the woman’s vagina is insufficiently moisturized. Therefore, a long foreplay is very important to properly stimulate the woman or the use of supporting lubricants. It also happens that we have intercourse right after menstruation (in fact, it may turn out to be its “ending”). Then, slight bleeding after intercourse may mean that you have not finished your menstruation.

Consult a gynecologist for disturbing symptoms. You can also talk to a specialist via e-visit. Make an appointment at a time convenient for you without leaving your home.

Bleeding after intercourse and cervical cancer

The most dangerous of the above-mentioned causes is cervical cancer. Every year, it affects about 4 women in Poland, almost half of whom die. Such poor treatment results are associated with a significant advancement of the disease at the time of diagnosis of a large proportion of this cancer in our country. Only regular Pap smears from the disc and cervical canal allow early detection of precancerous conditions and cancer and increase the chances of a cure. In countries where the enrollment of women for preventive smear tests is high, e.g. in Sweden, the mortality rate from cervical cancer is low.

One of the main symptoms of cervical cancer is bleeding during intercourse. This is because the lesion in the cervical region has a pathological surface that causes bleeding. If a tumor is suspected, it is necessary to perform a colposcopic or cytological examination. In addition, sometimes additional tests, e.g. ultrasound, should be supported. One should not forget about the medical history with the patient.

Treatment of cervical cancer is a long-term process, usually involving surgery, radiotherapy and chemotherapy. Therefore, it is very important to make a diagnosis early enough, which allows for the implementation of the fastest possible treatment and improvement of the prognosis.

Vaginal cancer

Bleeding after intercourse can also indicate vaginal cancer, which is a rare cancer of the female genital organs. Vaginal cancer is manifested not only by bleeding after intercourse, but also by pain while urinating and by blood-colored discharge. Vaginal discharge usually smells bad. Vaginal cancer is caused by HPV and the precancerous condition is vaginal intraepithelial neoplasia.

In the case of uterine abnormalities and diseases, diagnostic hysteroscopy is performed. An indication for the examination may also be infertility treatment and recurrent miscarriages.

Vaginal discharge and sexual intercourse

We rarely talk about vaginal discharge caused by sexual intercourse itself. We can often observe a situation when sperm flows out of the genital tract after intercourse, and there is also mucus, which is a natural lubricant. However, the occurrence of vaginal discharge after intercourse may be related to, for example, irritation of the vaginal walls. Irritation may occur as a result of the use of booster or lubricants that moisturize a woman’s vagina, which often trigger an allergic reaction. Post-intercourse discharge usually indicates inflammation developing in the genital area, regardless of sexual activity. The most common infections are bacterial, fungal and protozoal. A woman may get an infection from her partner. During sex, men can transmit various types of microorganisms, such as protozoa. A symptom of this type of ailment is an unpleasant smelling vaginal discharge that is often abnormally colored.

Bleeding after intercourse and cytology

Every woman, regardless of bleeding, should systematically perform a Pap smear test. In Poland, free primary health care or AOS tests are available for women aged 25-59. It is best to have a checkup once a year, while women who have had normal two previous smear test results can have a checkup every three years. Regular smear tests detect abnormalities in the cells of the cervix (precancerous condition). Detection of mild dysplasia requires conservative treatment and frequent gynecological monitoring. The pre-invasive stage of cervical cancer is 100% treatable.

Before any treatment is started, it is important to establish the cause of any bleeding after intercourse. Basic facts should be established:

1. the date of the last menstruation;
2. cycle length;
3. period of first menstrual bleeding;
4. regularity or irregularity in cycles;
5. number of sexual partners;
6. number of pregnancies or miscarriages;
7. past gynecological operations;
8. date of the last menstruation;
9. the presence of sexually transmitted infections;
10. past sexual abuse or rape of the patient (has it occurred?);
11. using gadgets that can cause bleeding during sex;
12. date of the last Pap smear test;
13. the presence of additional diseases, e.g. blood clotting disorders;
14. the occurrence of bleeding as a direct result of sex or as a consequence of irregular periods;
15. taking anticoagulants;
16. occurrence of other symptoms after intercourse in addition to bleeding, e.g. burning sensation, discharge, pain in the lower abdomen, pain during sex;
17. heavy menstruation;
18. bleeding or spotting between periods.

Sometimes it is necessary to perform other additional tests, e.g. colposcopy, vaginal ultrasound and hysteroscopy. Diagnostic tests also include: vaginal cleanliness, chlamydia test, syphilis test, and gonorrhea test.

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