Bleeding after sex: What you need to know

Picture the scene. You’ve just finished getting it on with a partner, so you pop to the toilet for a sensible, UTI-preventing post-sex pee. You wipe and notice you’re bleeding after sex.

If this has ever happened to you, you’ll know it can be quite worrying. Your mind can instantly jump to, “What’s wrong with me?!” But the reassuring news is that you’re not alone — up to 9% of menstruating women have experienced bleeding after sex. “[It’s] something that a lot of people experience from time to time, and it isn’t usually a sign of anything dangerous,” explains Dr. Jennifer Boyle, obstetrician and gynecologist, Massachusetts General Hospital, Massachusetts, US. 

Hopefully, it’s a relief to hear that postcoital bleeding — the medical term for non-menstrual vaginal bleeding that happens immediately after sex — isn’t unusual and in lots of cases, isn’t anything to worry about. However, it’s still good to speak to your doctor to make sure everything is okay. 

To get you clued up, Dr. Boyle explains why postcoital bleeding can happen and what to do if you notice blood on the sheets. First up: what actually is postcoital bleeding?

What is postcoital bleeding?

Coitus isn’t a term we use in everyday language. And that’s no surprise, considering it doesn’t exactly inspire sexy thoughts. But it simply means sex, so postcoital bleeding is just the medical term for any bleeding that you might experience during or after sex. This is any bleeding that isn’t your period, FYI.

Spotting blood on the sheets after being intimate can be alarming, especially if you’re not sure where it’s come from. If you feel a little bit freaked out, then it’s totally understandable, but it can be helpful to know where the blood might have come from. Most likely, it’ll have originated from your uterus, cervix, vagina, or any other organs and tissues in or near the vagina, like the anus. And it can happen for a variety of reasons, such as a sexually transmitted infection, damage to the vagina, or vaginal dryness. But more on this below. 

How long does bleeding after sex last?

Like many questions surrounding sex, it’s difficult to say how long bleeding after sex will last because it depends on what’s causing the bleeding. While some causes of postcoital bleeding can be handled at home, others warrant a trip to see your health care provider for further investigation and treatment. You might notice anything from a few drops, which is less concerning, to heavy bleeding, which you would need to speak to your doctor about right away. The bleeding may last for a couple of minutes, or perhaps it could be longer. 

If you’re worried at all about any bleeding you notice during or after sex, the best thing to do is reach out to your doctor. There’s no such thing as an embarrassing question, and your doctor will have heard about every sexual ailment under the sun. So don’t be shy; it’s important to let them know so they can advise you on what to do next. 

Is it normal to bleed after and during sex?

Many of us will experience some kind of spotting or bleeding during or after sex at some point. It’s hard to categorically say whether it’s “normal” or not because that mostly depends on how much you’re bleeding and whether it’s a regular thing. For this reason, while some bleeding after sex is quite typical, it’s really helpful to let your doctor know. 

If you’ve only noticed a few drops of blood in the toilet bowl, it might feel like you’re making a big deal out of nothing. But don’t think like that — it’s much better to let your doctor know than for you to worry at home. At the other end of the scale, if you consistently notice that you’re bleeding during or after sex, then it’s wise to call your health care provider. As Dr. Boyle says, “It’s always worth getting a checkup to make sure.” 

How to stop bleeding after sex

It’s tricky to know how to stop postcoital bleeding if you aren’t sure what’s causing it. That’s why it’s so important to call your doctor and let them know it’s happening. “Sometimes, we don’t find a cause for postcoital bleeding,” explains Dr. Boyle. But they’ll certainly try. As part of their investigation, your health care provider may invite you in for an appointment and ask you about your medical history. They might ask you about any changes to your period (if it’s gotten heavier or become irregular, for example) and if you’ve experienced any spotting throughout the month outside of your period. Sometimes it can be hard to remember all the details of your bleeding patterns, so using an app like Flo to track your cycle and log it all can make it easier.

Your doctor may also ask you if you’ve had any new sexual partners, when your last Pap smear was, and if you’ve noticed any change to the smell, color, or consistency of your discharge. They may want to do a physical exam to check for any tears or irritation around your vulva and inside your vagina to see what’s possibly caused the bleeding. They will also check for infections, and if you haven’t had a Pap smear for a while (longer than 3 years), they might offer you one. If you’re not sure what a Pap smear is or why you should have it, read up on it here.

These tests and questions might feel a bit thorough and intrusive, but they’re important because they will help your doctor get to the bottom of why you might be experiencing postcoital bleeding. And hopefully, they’ll help you stop it. 

What causes bleeding during or after sex? 

As we’ve mentioned, there is a whole load of reasons why you might bleed during and after sex. One of the most obvious answers to that question is that you might have started your period. It can be really helpful to track your cycle using an app like Flo, so your menstrual bleeding doesn’t catch you off guard.

But if you’re sure it’s not your period, then why else might you experience postcoital bleeding? These are some of the possible causes:

Damage to your vagina during sex 

While there’s a tendency to think bigger is better (thanks, porn!), the truth is that the more unwieldy the penis — or sex toy — the more likely your vagina is to tear and bleed. During rougher sex, you might also experience more friction, which means you could tear. Even if you’re comfortable with and enthusiastically consenting to this kind of sex, the reality is our vaginas are tender, delicate places. And, frankly, they can’t always cope with being poked, prodded, or pummeled indefinitely without some protection and care. 

If sex is painful or you’ve noticed that you’re bleeding afterward, talk to your partner about it. You may need to use a little extra lube or increase the amount of foreplay you do beforehand to ease both of you in. Remember, sex is meant to be a mutually pleasurable, safe experience, whatever you’re into — so make sure you’re both working within these parameters.

Infections or inflammation 

Bleeding after sex can also be a symptom of a number of different infections and conditions. Some are triggered by imbalances in the vagina, like yeast infections and bacterial vaginosis. But sexually transmitted infections (STIs) like trichomoniasis, chlamydia, and gonorrhea can also cause bleeding after and during sex.

If you’re bleeding after sex and experiencing any additional symptoms like unusual discharge, pain when you pee, pain during sex, or swelling or a rash around your vulva, see your doctor. They’ll check you over, invite you to take an STI test, talk through your symptoms, and explain your treatment options. 

Vaginal dryness 

As we mentioned above, sex is often better when it’s wetter — so vaginal dryness, sometimes called atrophic vaginitis, can mean sex becomes uncomfortable and painful. Luckily, this is easily explained, and your doctor will be able to help you resolve it. 

Vaginal dryness has been linked to some contraceptive pills, cold and allergy medications, and antidepressants. It also becomes increasingly common the closer you get to menopause (which is, on average, around the age of 51). This is because your estrogen levels drop, which can, in turn, affect how much discharge you have. It can also cause thinning, drying, and inflammation of the vaginal walls and the vulva as well. All in all, this can make for a pretty dry environment, but the good news is there are plenty of easy ways to tackle it.

First of all, make sure you’re relaxed and ready when you start having sex (especially penetrative sex) rather than rushing into things. When your body experiences sexual arousal, you get increased blood flow to your genitals — including the vaginal walls, which causes fluid to pass through them, making the tissues wet. Free lube, basically! And if you want to boost what your body creates, there are water-based lubricants that mimic the arousal fluid already there. 

For menopausal dryness, vaginal moisturizer is absorbed by the skin and can be used every day (it’s best applied regularly) to rehydrate your vaginal tissue. But a quick word of advice: before using any new products, it’s best to check with your doctor. 

Changes to your cervix

Your cervix is the donut-shaped tunnel that connects your vagina to your uterus. It’s small but super important. For example, it dilates when you give birth and stops tampons from getting lost inside you. See, we said it was important!

Growths on your cervix can be one reason why you might experience bleeding during and after sex. The term “growth'” might sound pretty scary, but try not to worry. Your doctor will be able to spot and diagnose them through an exam, and in many cases, they can be easily treated. 

One condition that may cause bleeding is cervical ectropion. This is where the cells from inside the cervix (called the endocervix) grow onto the outer part of the cervix. These cells are more likely to bleed, so when they get bumped during sex, it can result in some drops of blood. Another cervix-related cause of bleeding after sex can be polyps. These are noncancerous growths in the lining of the cervix. Very rarely, bleeding after sex can be a sign of cervical, uterine, or vaginal cancer, which is why it’s always important to see a doctor about it. But don’t get ahead of yourself worrying about this, as the chances of this being the case are very small.

It can be helpful to keep a record of when you bleed after sex or between periods (you can do this via the Notes function in Flo), so you can discuss patterns and frequency at your appointment. Make sure you schedule an appointment with your doctor ASAP — don’t feel as though you need to wait to establish a pattern before doing so.

What causes bleeding after anal sex?

The skin around your anus is also really sensitive. That means that during anal sex, friction can cause the skin to tear, which can cause bleeding and can be quite painful. This is sometimes called an anal fissure. Penetration with a penis, fingers, or sex toys can also cause dilated veins in the anus (known as hemorrhoids) to burst and bleed. 

It’s really important to speak to your doctor if you notice that you’re bleeding during or after anal sex. It might not feel like the most enjoyable conversation to have, but it’s key to share what’s going on with a health care professional so they can suggest the right thing to do next. 

Bleeding after sex while pregnant: Is it a reason for concern?

If you’re pregnant, you’ll already be aware that your body changes in lots of weird and wonderful ways. One of these is the new development of lots of blood vessels around your cervix. When you have sex, these can occasionally bleed, but a small amount of blood without any pain is no cause for concern. Still, it’s always good practice to see your doctor about new symptoms during pregnancy. And if you’re pregnant and you experience heavy bleeding during or after sex, seek medical attention straight away.

“[The blood] shouldn’t come out so quickly or heavily that it is soaking through a pad. It should not seem as heavy as a period,” advises Dr. Boyle. “Heavy bleeding is always a cause for concern in pregnancy and is a reason to call your provider right away.”

Heavy bleeding after sex: When to see a doctor

Whether you’ve noticed a few spots of blood on the toilet roll after your post-sex pee or a bigger stain on the bed, it can be hard to weigh when you should see your doctor about postcoital bleeding. But the bottom line? No matter how much blood you see, reach out. 

“Postcoital bleeding is definitely a reason to see your health care provider even if it is not heavy and even if it hasn’t been happening for a long time,” concludes Dr. Boyle. 

Bleeding after sex: The takeaway 

While postcoital bleeding is something that many of us will experience at some point in our lives, it doesn’t make it any less alarming when it happens. There are lots of causes of bleeding during and after sex — and many of them aren’t a sign of anything serious. 

That said, as a rule, it’s good to let your doctor know about any bleeding you’re experiencing. They may want to check you over and rule out any signs of infection. It’s always best to be sure.