Vaginal Health

Postcoital Bleeding: Why You May Bleed After Sex

August 2, 2018

It’s likely that if you are reading this, you’ve had an unexpected surprise after intercourse. Postcoital or after sex bleeding could be alarming at first, and of course a real mood killer. This sort of bleeding is not related to a menstrual cycle and the total amount of bleeding after sexual activity can vary from a scant amount of spotting to a thick, glowing red, sheet-soaking puddle.

Where the Bleeding Comes From

Obviously, there are lots of distinct ways to have sex. When talking about postcoital bleeding, we’re referring to bleeding that occurs after sexual activity when vaginal penetration is demanded. That means postcoital bleeding sometimes happens after vaginal penetration with a penis, a dildo, a partner’s finger…you get the point.

Anatomically, both components of your body which can bleed from the friction or comparative trauma of vaginal sex would be the vagina and your own nipples.

Reasons for Vaginal Bleeding

Whenever your vagina bleeds after intercourse, it is probably caused by direct injury to the wall of your vagina. This is known as a vaginal laceration and the bleeding is bright red and can be quite heavy.

Normally, the vagina does not tear with sex. If the vagina isn’t well lubricated, the friction brought on by vaginal penetration may tear the walls of the vagina. You may experience inadequate vaginal lubrication if any of the following occur:

  • Vaginal penetration occurs before you’re aroused sufficient to self-lubricate.
  • Your estrogen levels are reduced. This happens during breastfeeding and together with menopause.
  • You have had remarkably rough sex or a foreign object can be used for vaginal penetration. This includes if your partner has genital piercings or implants, such as alloy barbells.

    Although not as common, vaginal lacerations are usually the cause of postcoital bleeding that is heavy enough to attract a girl to the emergency room after sex. The vagina has a rich blood supply and these kinds of lacerations bleed a lot. Ordinarily, it means stitches or suturing have been needed to stop the bleeding. Sometimes it also means a visit into the operating room.

    Reasons For Cervical Bleeding

    Unlike the vagina, bleeding from the cervix after intercourse normally is not heavy enough to attract you to the emergency room in the middle of the night. Typically there’s a limited amount of bright red blood. It can be so minimal that you only notice it if you are wiping yourself or changing your sheets. Even though it may be minimal, it is still important to go over any bleeding after sex with your healthcare provider.

    Essentially there are four reasons why your cervix may bleed after intercourse, for example:

    1. Cervical ectropion: The cervix has two areas and two kinds of cells. The exterior of the cervix has the same kind of cells since the vagina although the inside or canal of the cervix has a different type of cell. The cells which protect the cervix act as a barrier and are resistant to the vaginal environment, for example, friction of intercourse. On the other hand, the cells that line the canal of the cervix are considerably more fragile. Cervical ectropion refers to an illness or an anatomical form in which the canal of the cervix is turned inside out, exposing these more fragile cells to the vaginal environment. Pregnancy and birth control pill use could be associated with these changes. These cells bleed quite easily when touched even lightly. If you have this version of your cervix, it is very likely that you will have postcoital bleeding.
    1. Cervical polyps: The cells which line the canal of the cervix may also make polyps. Endocervical polyps are usually benign growths. Because they have such a rich blood supply, they bleed easily. These polyps grow in the canal of your cervix but as they grow they stay out of the conclusion of the cervix, placing them in the ideal position to become irritated and bleed through intercourse.
    2. Cervicitis: Infection of the cervix, known as cervicitis, can also cause bleeding after sexual intercourse. Chlamydial infection is the most frequent cause of severe cervicitis. In the first phases, a chlamydial disease does not have any real symptoms but it is a serious sexually transmitted disease that can affect your fertility. It is extremely important to understand your healthcare provider if you’re having any fresh onset postcoital bleeding.
    1. Cervical cancer: This is by far the most serious cause of postcoital bleeding. But, it’s also the least likely cause. This is particularly true if you have been seeing your health care provider for routine cervical cancer screening. Of course, cervical cancer is the very first thing you will find in an online search for postcoital bleeding. If you’re reading this, have a big cleansing breath and don’t panic. There are lots of other possible causes of your postcoital bleeding and there is no need to presume it is cervical cancer straight away. However, it’s important to discuss postcoital bleeding or any other issues you have with your health care provider.

    See Your Healthcare Provider

    If you are having postcoital bleeding, you can also be experiencing abnormal uterine bleeding which isn’t related to sex. Approximately 30 percent of women who bleed during sex also have other episodes of abnormal bleeding out their regular monthly interval. 

    Postcoital bleeding is typically painless. Only about 15% of women with bleeding after sex will even complain of pain with sex, known as dyspareunia.

    It is important that you find out your healthcare provider if you are experiencing postcoital bleeding. To help your physician determine the cause of your bleeding, Consider how you would answer these questions:

    • Do you have a new sex partner?
    • When did the bleeding start?
    • Do you practice safe sex?
    • Can you use any sex toys or other foreign objects during intercourse?
    • Do you have pain with sexual intercourse?
    • Can you bleed after intercourse or at certain times of the month or in certain places?
    • Can you have bleeding out of your normal period which isn’t related to sex?

    You might feel uncomfortable or embarrassed about discussing bleeding after sex with your doctor, but your sexual health is an significant part your overall health and it is very critical that you bring it up, even when your doctor forgets to inquire. And if your physician doesn’t make the dialogue easy for you, maybe you should consider finding a new one.