There are many reasons women experience bleeding after sex. The medical term is postcoital bleeding. It occurs in women of all ages. In younger women who haven’t reached menopause, the source of the bleeding is usually the cervix. In women who have gone through menopause, the source of the bleeding is more varied. It can be from the:
- cervix
- uterus
- labia
- urethra
Causes of bleeding after sex
Bleeding after sex can be a sign of an underlying health condition:
Infection, such as pelvic inflammatory disease (PID), or a sexually transmitted infection (STI), such as chlamydia
Vaginal dryness (atrophic vaginitis) caused by reduced vaginal secretions after the menopause
Damage to the vagina, such as tears caused by childbirth, or by dryness or friction during sex
Cervical or endometrial polyps (benign or non-cancerous growths in the womb or the lining of the cervix)
Cervical ectropion (also known as cervical erosion), where there is an inflamed area on the surface of the cervix
In rare instances, bleeding after sex can be a sign of cervical or vaginal cancer.
Tests and examinations
Depending on any other symptoms and your medical history, we may recommend some tests or examinations, such as:
An Ultrasound
Pregnancy test (depending on your age)
A Pelvic examination looking at the cervix with an instrument called a speculum
If the problem is caused by vaginal dryness, they may recommend that you try using lubricating gels.
Many women experience vaginal bleeding after sex at one time or another. In fact, up to 63 percent of postmenopausal women experience vaginal dryness and vaginal bleeding or spotting during sex. Additionally, up to 9 percent of menstruating women experience postcoital bleeding.
Infections
Some infections can cause inflammation of the tissues in the vagina, which may lead to bleeding. These include:
- pelvic inflammatory disease
- sexually transmitted disease (STD)
- cervicitis
- vaginitis
- Genitourinary syndrome of menopause (GSM)
GSM was formerly known as vaginal atrophy. The condition is common in women in perimenopause and menopause, and those who’ve had their ovaries removed. As you get older, especially when your menstrual periods stop, your body produces less oestrogen.
When your oestrogen levels are lower, several things happen to your vagina. Your body produces less vaginal lubrication, so your vagina can become dry and inflamed. Lower oestrogen levels also reduce the elasticity of your vagina. Vaginal tissues become thinner and shrink. This can lead to discomfort, pain, and bleeding during sex.
Polyps
Polyps are noncancerous growths. They’re sometimes found on the cervix or in the endometrial lining of the uterus. A polyp dangles like a round pendant on a chain. Polyp movement can irritate the surrounding tissue and cause bleeding from small blood vessels.
Vaginal dryness
Vaginal dryness can lead to bleeding. In addition to GSM, vaginal dryness can be caused by many other factors, such as:
- breastfeeding
- childbirth
- having your ovaries removed
- certain medications, including cold medicine, asthma medications, some antidepressants, and anti-estrogen drugs
- chemotherapy and radiation therapy
- having intercourse before you are fully aroused
- douching
- chemicals in feminine hygiene products, laundry detergents, and pools
- Sjögren’s syndrome, an inflammatory disease of the immune system that reduces moisture generated by glands in the body
Vaginal tearing
Sex, especially vigorous sex, can cause small cuts or scrapes to the vagina. This is more likely to happen if you have vaginal dryness due to menopause, breastfeeding, or other factors.
Cancer
Irregular vaginal bleeding, including bleeding after sex, is a common symptom of cervical or vaginal cancer. In fact, it was the symptom for which 11 percent of women diagnosed with cervical cancer first sought treatment. Postmenopausal bleeding can also be a symptom of uterine cancer.