Bleeding after sex, also known as post-coital bleeding, is in most cases nothing to worry about, but in some rare cases it may be a sign of something more serious and should always be explored further by a health professional or your GP.
There are a few reasons why women may experience postcoital bleeding from a lack of lubrication, through to the more serious bleeding due to an STI. The vaginal bleeding may also present as a brown or pink discharge or ‘spotting’ of blood after sex, which as the name suggests, is small spots of blood on your underwear or toilet paper.
Possible reasons for bleeding after sex
Friction during sex, and not enough lubrication – if your body hasn’t naturally lubricated, friction may cause the vaginal tissues to tear.
Childbirth – childbirth can make the vaginal tissues more vulnerable to injury.
Loss of virginity – resulting in the hymen breaking.
Menopause – after the menopause, lower levels of oestrogen can make the vaginal walls thin, dry and inflamed.
Medications – some medications can cause vaginal dryness including some antidepressants, allergy pills and cold/flu remedies.
Chemicals – some chemicals cause vaginal dryness including laundry detergents, feminine hygiene products and swimming pool chemicals.
Douching – having sex immediately after bathing or showering can result in friction that causes the vaginal tissues to tear.
Engaging in sex before arousal – not giving your body time to naturally lubricate.
Sexually transmitted infections – STIs such as chlamydia and gonorrhea can cause serious damage including vaginal bleeding and need to be treated immediately.
Ectropion – cervical ectropion can be a very common cause of bleeding which can develop due to contraception, especially with the combined oral contraceptive pill. The condition is caused when the lining of the womb grows out over the cervix, and can cause bleeding after contact during sex.
Polyps – Some women may find they develop small benign growths on their cervix called a polyp. As these are full of vessels they can bleed a lot. In some cases, your GP may send you to a specialist to assess whether it is definitely benign and look to remove it.
Pelvic inflammatory disease – women experience pain in the lower abdomen, vaginal discharge and irregular vaginal bleeding.
Fibroids – Fibroids can grow on the inside of the uterus and cause abnormal vaginal bleeding
Endometriosis – Endometriosis is when the tissue that normally lines the inside of your uterus, lines the outside. A common symptom of endometriosis is postcoital bleeding.
Cervical cancer – In rare cases, bleeding after sex can be a sign of cervical cancer. Other symptoms may present as pain during or after sex, an unpleasant vaginal discharge and pain in the pelvis or lower back.
Is it normal to bleed after losing your virginity?
It is perfectly normal for a woman to bleed after sex the first time they have sexual intercourse. Not all women may experience postcoital bleeding in this instance, but for those that do it is perfectly normal to experience some light vaginal bleeding.
This is because of the hymen breaking, which is a small piece of skin that covers the entrance of the vagina. The hymen may have broken prior to a woman losing her virginity, through activities such as sports and so in this case a woman may not experience bleeding the first time they have sex.
Is my contraceptive pill making me bleed after sexual intercourse?
Certain types of contraception may cause bleeding at irregular times of the month which may coincide with sexual intercourse. Many of our contraceptive reviewers found they experienced spotting or bleeding on the pill, and in particular, those who use the progestogen-only pill (also known as the mini pill) such as Cerazette or Noriday found they experienced irregular bleeding.
Is bleeding after sex a sign of pregnancy?
When your body undergoes pregnancy, it goes through a variety of changes, particularly your cervix. You may experience a pinkish or brown discharge or some blood spotting after sex during the first few months of your pregnancy. It happens due to the developing embryo implanting itself in the wall of your womb and the bleeding will happen normally when your period would have been due.
Postmenopausal bleeding after sex: should I call a doctor?
Oestrogen is what keeps your vaginal tissues healthy, so when a woman’s oestrogen levels drop during the menopause it can cause her vaginal walls to become thin, dry and inflamed. This is known as vaginal atrophy. Therefore when a woman has sex it can often lead to bleeding. Using a lubricant will help, but if the problem persists then make an appointment with your doctor.
When to see a doctor for spotting or bleeding after sex?
The symptoms you may experience with postcoital bleeding may vary depending on the cause. If you have minor spotting or bleeding that goes away quickly you may not need to see a doctor. But if you have persistent bleeding after sex then you should immediately contact your GP, who will examine your cervix to look for serious causes.
If you continue to have bleeding ongoing for three months and have been diagnosed with a normal cervix, then recontact your GP who will refer you to a colposcopy clinic where you will have a more detailed examination of the cervix.