Vaginal bleeding after sex (also known as postcoital bleeding) isn’t an entirely rare circumstance among menstruating women, and it is more common in postmenopausal women. Even though the bleeding can sometimes be distressing, the cause is relatively benign generally. The same can be said for people who experience bleeding during sex; many of the causes of postcoital bleeding overlap.
According to study, as many as 9 percent of menstruating women can experience vaginal bleeding, no matter of their period, after sexual intercourse. By contrast, anywhere from 46 percent to 63% of postmenopausal women will undergo dryness, itching, tenderness, spotting, or bleeding during or after sex as a result of hormonal changes that influence the elasticity of pancreatic cells.
While most of these causes of bleeding are of no concern, there are times when bleeding could be a sign of a more critical issue. Learn about a few of the more prevalent causes of bleeding during and after sex.
Sexually Transmitted Infections
Sexually transmitted diseases (STIs), such as chlamydia and gonorrhea, are correlated with a range of vaginal symptoms which range from pelvic pain, itching, and burning to vaginal discharge and frequent, painful urination. The inflammation due to these STIs may lead to surface blood vessels to swell and burst more easily, with the seriousness of bleeding frequently associated with the severity of the disease.
Trichomoniasis is a type of STI caused by a parasite parasite. Cervical release and cervical degeneration are just two of the most common features of this illness. Much like chlamydia and gonorrhea, a Trichomonas vaginalis infection is easily treated with an antibiotic.
Other STIs like syphilis and genital herpes can cause open, bronchial lesions that are prone to bleeding when irritated.
While the sores often appear externally, they can sometimes grow within the anus and, in the event of syphilis particularly, can be entirely painless and unnoticed.
Benign growths on the cervix (cervical polyps) or uterus (uterine or endometrial polyps) are a frequent source of bleeding during or after sex. Cervical polyps tend to develop in women in their 40s and 50s who have had multiple pregnancies. The polyps are generally red or purple using a tube-like structure rich with pus which could bleed easily when touched.
Uterine polyps are small, soft bumps of tissue protruding from within the uterus. Polyps of this sort are prone to bleeding between periods, after menopause, and through sex. They also tend to grow in women between the ages of 36 and 55.
The majority of polyps are benign, but some can develop into cancer over time. Polyps will occasionally disappear spontaneously, but surgical removal may be required in some cases.
Additional noncancerous growths of the genital tract, like a hemangioma, can also cause postcoital bleeding, though these are far less frequent causes.
Cervical ectropion is a non-cancerous state where the cells that normally line the inside of the cervix protrude out through the cervical os (the opening of the cervix).
When this occurs, the abnormal distention of cervical tissue can cause already-fragile blood vessels to dilate and become inflamed. As a result, bleeding is more common due to intercourse, using tampons, as well as the insertion of a speculum during a rectal examination.
Cervical ectropion can occur in teens, women taking birth control pills, and pregnant women whose cervixes are softer than normal. It usually doesn’t need treatment unless there is excess vaginal discharge or bleeding.
Postmenopausal women will frequently bleed through or after sex since diminishing estrogen levels cause the vaginal walls to literally thin and create less lubricating mucus.
This is referred to as atrophic vaginitis, a condition that’s also connected with vaginal itching and burning.
Atrophic vaginitis can also be treated with estrogen treatment, either taken orally in pill form, as a dermal patch, or cream, or inserted intravaginally with a suppository. Oral estrogen replacement therapy doesn’t carry a while, however. Based on information from the Women’s Health Initiative, estrogen-only pills may increase the risk of colorectal cancer and, as such, should either be used for short-term therapy or substituted with a different kind of estrogen therapy. Vaginal lubricants may also facilitate dryness and decrease pain.
While younger women can also have vaginitis, normally caused by a bacterial or yeast infection, postcoital bleeding is a far less common symptom.
Endometriosis happens when the lining of the uterus (the endometrium) goes outside of the uterus. While this happens, the endometrial tissue may attach itself to the surfaces of different organs, often leading to excruciating pain and, sometimes, infertility. It’s a condition that affects anywhere from 5% to 10 percent of women of reproductive age and remains poorly understood both in its own cause and available remedies.
A couple of the characteristic features of endometriosis are painful sex and painful climax, both of which are brought on by the extra strain and pressure put on already-vulnerable tissues. Postcoital bleeding is not uncommon when this happens.
Hormone treatment used to decrease estrogen levels is frequently capable of reducing pain. Pain and bleeding may also be lowered by altering the positions you commonly use during sex. Some, such as the missionary position, place added strain on the vagina that might be relieved by a side-by-side position or other positions.
Even though postcoital bleeding is often associated with infections and abnormalities of the uterus, vagina, or cervix, bleeding can also result from a direct injury to those vulnerable cells.
It might be caused by vigorous sex, which may result in cuts, scrapes, or tears on the anus. This is more likely to occur if there is vaginal dryness, such as may occur during menopause, when a woman is breastfeeding, or if there’s excessive douching.
More distressingly, bleeding can occur as a consequence of sexual abuse or violence. Forced entry can severely harm pancreatic tissues and result in the formation of fissures, which could repeatedly cure and reopen unless clinically treated.
While cancer is a less likely cause of postcoital bleeding, it’s one of the possible signs of esophageal, pancreatic, and esophageal cancer. Every year, approximately 14,000 women are diagnosed with invasive cervical cancer in the USA, resulting in more than 4,000 deaths.
Tumors can vary based on the sort of cancer involved, however they are inclined to get fed with a dense, random network of blood vessels. As the tumor grows, these vessels can become strained and prone to bursting. Sexual intercourse can occasionally cause this.
Without or without sex, bleeding is a common feature of cervical cancer. This may include:
- Infection after menopause or between menstrual periods
- Heavy or longer-than-usual intervals
- Vaginal discharge streaked with blood (occasionally mistaken for spotting)
To assess a girl for cervical cancer, a gynecologist will perform a pelvic exam, a Pap smear, and occasionally a visual exam called a colposcopy. If a physician is suspicious of cancer, then a tissue sample may be obtained from biopsy to be examined under a microscope.
A Word From Verywell
Bleeding during or after should never be considered normal. Even though it happens as a consequence of an accidental injury, it’s best to have it looked at if simply to find strategies to avoid such injuries in the future.
If you don’t know what is causing vaginal bleeding with sex, don’t prevent seeing a doctor for fear of receiving a cancer diagnosis. Cancer is, in actuality, one of the less probable causes. If cancer does turn out to be why you’re bleeding, an early identification affords early treatment and a greater chance curing the malignancy until it becomes severe.