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Vaginal Bleeding after Sex and Bleeding During Sex: Causes and Risk Factors

Have you ever experienced bleeding during or after sex? It may seem scary at first, but it’s more common than you might think. Today, we’ll investigate possible reasons for heavy bleeding after sex and identify risk factors associated with bleeding during sex.

Vaginal Bleeding During and After Sex

What causes bleeding after sex?

Among other things, bleeding after sex can be caused by menopausal side effects or it can be the sign of a more serious condition. Vaginal bleeding after sex is also called postcoital bleeding and can be caused by:

  • Cervical inflammation (cervicitis) — Cervicitis can be ongoing and totally harmless, or it can happen because of a sexually transmitted infection that needs to be treated, like chlamydia or gonorrhea. 
  • Vaginal dryness — During menopause, the hormones in your body change. The level of estrogen decreases and may lead to a decrease in vaginal fluid. During sex, this decrease causes vaginal dryness, and the resulting friction can irritate the tissues that line the vagina and cause pain. This can be alleviated with the use of some water-soluble lubricant. 
  • A cervical polyp — Polyps are growths that are usually small (1–2 centimeters) and appear on the cervix where it meets the vagina. Most polyps are non-cancerous and can be removed by your OB/GYN during an appointment.
  • Normal uterine bleeding — This can happen just before or just after your period. Shortly before or after your period, it is normal to experience light bleeding after sex. This may appear as light spotting.
  • Cancer — Cancer can involve the vagina, cervix, and uterus. Make sure you schedule regular appointments with your doctor to have regular Pap and pelvic exams, which can help detect early signs of cancer.

While some of the causes of bleeding during or after sex don’t need treatment and are harmless, sometimes vaginal bleeding after sex can be a sign of a more serious problem.

male and female in bed afraid of bleeding after sex

Causes of bleeding during sex

Vaginal bleeding during sex can be caused by many of the same things that can cause bleeding after sex. These include infection, vaginal trauma due to dryness, cervical polyps, menopause, and cancer. However, there are some other conditions that can cause bleeding during sex specifically. These can include:

  • Endometriosis — This medical condition causes endometrial tissue to grow where it isn’t supposed to (outside the uterus). Because of this, many people with endometriosis report irregular cycles and bleeding or spotting between periods. This can cause bleeding during and after sex.
  • Contraception — Whenever you start or change your type of contraception, bleeding can happen between periods. However, if you experience heavy bleeding during sex, make sure to talk to your doctor about it. 
  • Pregnancy — Early pregnancy can also cause light bleeding during sex. When bleeding during sex is caused by early pregnancy, it is typically a small amount of spotting when you do not expect your period. Make sure to take a pregnancy test if you think this might be the cause of your bleeding during sex.
  • Postpartum — The uterus and vagina can take up to four to six weeks to completely heal after childbirth. During this time, your bleeding after delivery (lochia) will slow down and may even stop for a few days. Even after stopping briefly, it can start up again at unexpected times. 

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Bleeding after anal sex: what are the possible reasons?

The tissue that lines the rectum is very sensitive and can tear easily. Bleeding after anal sex can be caused by the insertion of a finger, penis, or sex toys. Bleeding after anal sex can also be caused by friction, rough or aggressive intercourse, or by rough edges on objects that may be inserted through the anus into the rectum.

If you’re bleeding after anal sex, you may need to add or use more water-soluble lubricant to prevent these types of injuries. Bleeding from sex can lead to additional health concerns. This is even more important if you bleed during or after sex every time you and your partner engage in intercourse. If this happens, you may need to visit your doctor and/or make some changes to the way you have sex.

How long after sex does implantation bleeding occur?

It is difficult to determine exactly how long it takes after conception for implantation bleeding to occur. During a normal menstrual cycle, the optimal time to conceive usually lasts 12–24 hours. However, sperm can live up to five days in a woman’s reproductive organs. This means that you could have sex that leads to pregnancy up to five days before ovulation.

Once an egg has been fertilized, it undergoes multiple stages of cell division. Once it has reached day five or six, it is ready to start the implantation process. This implantation process may result in some light bleeding or spotting, but you should not experience implantation bleeding one or two days after sex. If it happens, implantation bleeding will be the result of sex that you and your partner had up to about 10 days ago. 

woman having abdominal pain and bleeding after sex

Bleeding after sex during pregnancy: should you be worried?

Light bleeding during the first 12 weeks of pregnancy is not uncommon. The cause of this spotting may be the implantation of the egg into the blood-rich uterine lining. In this case, light bleeding after sex should not be concerning. 

During the first trimester, you are most vulnerable to miscarriage. If you experience any bleeding and/or cramping, contact your doctor immediately. 

Once you have reached your second trimester (after 12 weeks), it is less likely for you to miscarry and light bleeding after sex (spotting) is fairly common. This is because the cervix and uterus have an increased amount of blood supplying these areas. Because of this, it may be easier for small blood vessels to be damaged during intercourse. 

If you are experiencing light bleeding after sex without cramps, it may be because your partner’s penis is making contact with your cervix. To help alleviate this, try different sex positions that might be more comfortable. If you have any concerns at all, it’s best to speak to a doctor.

Heavy bleeding every time after sex: when to see a doctor

Bleeding after sex can be a fairly common situation. Doctors tend to be more concerned when a pregnant woman is bleeding after sex or when a woman is postmenopausal and bleeding after sex. However, heavy bleeding after sex is only normal if it is related to your period. 

Pay attention to how often you need to change your pad or tampon and if you are passing any clots. If you’re experiencing heavy bleeding after sex that’s not related to your period, it’s important to seek medical attention as soon as possible. This is especially true if you need to change your pad or tampon every hour and/or are passing clots larger than a quarter. If you cannot get in to see your doctor, a visit to the emergency department may be necessary.

https://doi.org/10.1177/1933719116654994

https://www.ucsfhealth.org/education/conception_how_it_works/.

https://www.mayoclinic.org/symptoms/vaginal-bleeding/basics/definition/sym-20050756

Women's Health in Primary Care. A. Connolly, A. Britton. Cambridge university press, 2017
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5933199/

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