So you just finished a romp in the sack, and now you’re noticing some bleeding. Before you panic, take a few deep breaths. Bleeding during or after sex, while jarring in the moment, isn’t necessarily serious, especially if it happens as a one-off thing.
“It’s fairly common,” says Nicole Williams, MD, fellow of The American Congress of Obstetricians and Gynecologists and founder of The Gynecology Institute of Chicago. More formally known as postcoital bleeding, it refers to bleeding that’s a result of penetration of any kind, Dr. Williams says. Many times, it’s caused by some irritation after rough sex, or it could also just be the beginning or tail end of your period. But Dr. Williams notes that it’s best to investigate any bleeding you’re noticing happening more than once to ensure there isn’t a health issue behind it.
And for the record, it’s not just penis-in-vagina sex that can result in this bleeding. Any type of penetration, whether it be from a finger or toy, can lead to bleeding.
Want to know more? No need to crowdsource from your friends: Women’s Health rounded up all the info you need, straight from ob-gyns, about the common causes of bleeding during or after sex, including how to treat it, and when to check in with your doc about it.
What are some common reasons for bleeding during sex?
Vaginal Tearing
It might make you wince just thinking about it, but tearing is a common cause of postcoital bleeding. Here’s the good news: It could just be that the sex you had was a bit rougher than you’re used to, or that you were particularly dry. “Tearing can happen with normal sex (especially if you are with a well-endowed partner) or rough sex,” says Brandye Wilson-Manigat, MD, fellow of The American Congress of Obstetricians and Gynecologists and a board-certified ob-gyn and a women’s pleasure coach. “It can also occur if you are experiencing vaginal dryness due to breastfeeding, certain medications, or menopause,” adds Dr. Wilson-Manigat. Taking hormonal birth control can be a source of dryness, and therefore some tearing after sex and bleeding, too.
In other cases, the light bleeding could be a result of a skin condition that caused some tearing.For example, a medical skin condition called lichen sclerosus, which can contribute to irritation and itching of the vulva in the prepubescent stage and after menopause, is also a source of tearing or bleeding after sex, Dr. Wilson-Manigat explains.
Thankfully, the vulvar and vaginal tissues, for the most part, are generally pretty elastic, which allows for stretching without too much tearing, she elaborates. But as you get older, your vaginal tissue becomes less elastic and is prone to tearing.
Also worth noting: Slight tearing could be more likely if you haven’t had sex or been penetrated at all recently. “If it’s been a while since you’ve had sex, the tender skin around the vagina may have a microtear and cause some spotting,” offers Dr. Williams.
Your best bet is going to be loading up on lube in preparation for sex, especially if you’re dry to begin with. Dr. Wilson-Manigat suggests using a high-quality water-based or silicone-based lubricant to help prevent this sitch from happening in the first place.
Cervical Polyps
Cervical polyps are one of the more common reasons for bleeding during sex that Dr. Wilson-Manigat has seen in her practice. “These are benign growths on the cervix that are similar to a skin tag you would see on another area of your body,” says Dr. Wilson-Manigat. “But the difference between a skin tag and a polyp is that polyps can bleed very easily with light touch, which is why you may have bleeding from them during sexual activity.”
Most of the time, they can be found during your routine pelvic exam and pap smear, so check in with your gyno if you think you might be prone to polyps.
Early Pregnancy
Before you’ve even taken a test, light bleeding could be your first clue that you’re pregnant. One of the first signs of early pregnancy can be vaginal bleeding, also known as implantation bleeding, that can occur right after sex, says Alexandra Bausic, MD, a board-certified gynecologist. The cause of the bleeding is the implantation of the embryo inside your uterus, so it may show up at any time, unrelated to penetration, Dr. Bausic notes.
If you think there’s a chance you could be pregnant, and you’re noticing bleeding during sex or in general, take a test and then give your gyno a call.
Cervicitis
Another one of the more common explanations for bleeding during or after sex is cervicitis.While the word may sound scary, what’s basically happening is an inflammation of the cervix, says Dr. Williams.
In some cases, a common infection such as bacterial vaginosis (BV) or an allergic reaction to latex condoms or certain feminine hygiene products causes the inflammation in the cervix, according to the Mayo Clinic.But cervicitis can be easily treated with a topical antibiotic, Dr. Williams says.
Pelvic Infection
Sometimes, bleeding during or after sex could be a sign of a pelvic infection, according to Dr.Wilson-Manigat. When your cervix is infected, the tissue becomes swollen and red, as your body tries to rush more blood and white blood cells to the area to fight the infection. “This makes the cervix overly sensitive to tears and bleeding, and it can bleed with or without any direct stimulation,” she explains.
There’s a slight chance that the infection causing postcoital bleeding is chlamydia or gonorrhea, so your ob-gyn may run an STI test to be safe when you visit with this issue, Dr. Wilson-Manigat says.In rare cases, an HPV infection could be causing some type of cervical precancer (but your doctor will flag any abnormalities with your pap smear first).
It’s not always a sexually transmitted infection causing the bleeding, though. Some other infections that may be to blame for postcoital bleeding are BV or yeast infections, says Alyssa Dweck, MS, MD, FACOG, Fellow of The American Congress of Obstetricians and Gynecologists, an ob-gyn, Bonafide Medical Advisor, and author of The Complete A To Z For Your V.
The best way to prevent bleeding that’s related to STIs is to use protection during sex, Dr. Wilson-Manigat adds.
So I should really see a doc if I bleed during or after sex?
Definitely if it’s a recurring thing. Here’s Dr. Williams’ rule of thumb: “If you have a single episode of bleeding after sex, especially if you’re just finishing your period or have started a new hormonal birth control, it may not be anything to be concerned about. However, if it happens more than once, it’s best to just make a quick visit to the gyno and have yourself checked out.”
Dr. Williams also advises women to pay attention to the color of the blood. “Darker blood is usually older blood, and is not as concerning as if it were very bright red,” she says. (The dark blood could just be remnants of your period.)Take note if the blood is accompanied by pelvic pain and discomfort, as well as if your vaginal discharge has a different texture or smell, so you can provide your ob-gyn with as much information as possible to help ID your condition, Dr. Bausic adds.
In terms of treatment, rest assured that many of these conditions are treatable once your doctor is able to diagnose you with the infection or skin condition. One way to rule out infections before you’re even in the doctor’s office is by making sure that pregnancy or any kind of potentially irritating external products aren’t causing the bleeding, Dr. Dweck says.
For many one-time occurrences of bleeding during sex, using lube the next time around is going to do the trick. But if you’re using lube and that’s not helping, it’s best to look further into what could be causing the bleeding. It’s true that sex can be messy—and while talking about bodily fluids and blood can sometimes be uncomfortable, your gyno is trained to help you. That way, you can make sure sex gets back to what it should be: fun!
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