Bleeding after sex: causes, risk factors and more


Many women experience vaginal bleeding after having sex at one time or another. In fact, up to 63 percent of postmenopausal women experience vaginal dryness and vaginal bleeding or spotting during sex. In addition, up to 9 percent of menstruating women experience postcoital bleeding.

Occasional light bleeding is usually not a cause for concern. If you have certain risk factors or have gone through menopause, bleeding after intercourse justifies a visit to the doctor.

Causes of bleeding after sex

Bleeding after having sex is medically known as postcoital bleeding. It occurs in women of all ages. In younger women who have not reached menopause, the origin of bleeding is usually the cervix. In women who have gone through menopause, the source of bleeding is more varied. It can be from the

  • cervix

  • uterus

  • vaginal lips

  • urethra

In terms of causes, cervical cancer is the biggest concern. This is especially true for postmenopausal women. However, postcoital bleeding is more likely to be caused by a common condition.


Some infections can cause inflammation of the tissues in the vagina, which can lead to bleeding. These include:

  • pelvic inflammatory disease

  • sexually transmitted disease (STD)

  • cervicitis

  • vaginitis

Menopausal genitourinary syndrome (GSM)

GSM was previously known as vaginal atrophy. The condition is common in women in perimenopause and in menopause, and in those who have had their ovaries removed. As you get older, especially when your menstrual periods stop, your body produces less estrogen. Estrogen is the female hormone responsible for regulating your reproductive system.

When your estrogen levels are lower, several things happen to your vagina. Your body produces less vaginal lubrication, so your vagina can dry out and inflame. Lower estrogen levels also reduce the elasticity of your vagina. The vaginal tissues shrink and shrink. This can cause discomfort, pain and bleeding during sexual intercourse.

Vaginal dryness

Vaginal dryness can lead to bleeding. In addition to GSM, vaginal dryness can be caused by many other factors, such as:

  • breast-feeding

  • Birth

  • having removed the ovaries

  • certain medications, including cold medications, asthma medications, some antidepressants, and antiestrogenic medications

  • chemotherapy and radiotherapy

  • have sex before you are completely excited

  • showers

  • Chemical products in feminine hygiene products, laundry detergents and swimming pools.

  • Sj√∂gren's syndrome, an inflammatory disease of the immune system that reduces the humidity generated by the body's glands.

More information: Postpartum vaginal dryness »


Polyps are non-cancerous growths. Sometimes they are found in the cervix or in the endometrial lining of the uterus. A polyp hangs like a round pendant on a chain. The movement of the polyp can irritate the surrounding tissue and cause bleeding of small blood vessels.

Vaginal tearing

Sex, especially vigorous sex, can cause small cuts or scratches in the vagina. This is more likely to happen if you have vaginal dryness due to menopause, breastfeeding or other factors.


Irregular vaginal bleeding, including bleeding after having sex, is a common symptom of cervical or vaginal cancer. In fact, it was the symptom by which 11 percent of women diagnosed with cervical cancer first sought treatment. Postmenopausal bleeding can also be a symptom of uterine cancer.

Are you at higher risk of bleeding after having sex?

You may have a higher risk of postcoital bleeding if:

  • have cervical or uterine cancer

  • are in perimenopause, menopause, or are postmenopausal

  • Recently I had a baby or we are breastfeeding.

  • have sex with multiple partners without using condoms

  • are not completely excited before coitus

  • showering frequently

Consult a doctor for these symptoms

The symptoms you may experience along with postcoital bleeding vary depending on the cause. If you are not menopausal, have no other risk factors, and have only minor blemishes or bleeds that disappear quickly, you may not need to see a doctor. If you have any vaginal bleeding after menopause, consult your doctor immediately.

You should also consult your doctor if you have any of the following symptoms.

  • vaginal itching or burning

  • stinging or burning sensation when urinating

  • painful sexual intercourse

  • heavy bleeding

  • severe abdominal pain

  • low back pain

  • nausea or vomiting

  • unusual vaginal discharge

What happens when you see your doctor?

You can visit your GP or gynecologist for postcoital bleeding. Your doctor will ask you about your symptoms, for example, how long and how much you have bled. They can also ask about the color of the blood.

Because your symptoms are related to sexual activity, your doctor may also ask about your sexual history. For example, they may ask you if you use condoms regularly or if you have more than one sexual partner.

Depending on your symptoms and sexual history, your doctor may recommend a physical exam. Examining the area can help your doctor find the source of the blood. Postcoital bleeding can come from the vaginal walls, the cervix, the urethra, or the vulva.

To help determine what is causing the bleeding, your doctor may also order tests, such as a Pap test, a pregnancy test, and vaginal cultures to screen for sexually transmitted diseases.

Many women hesitate to visit their doctor about a sexual health issue if they find pelvic exams uncomfortable. However, consulting your doctor about postcoital bleeding does not necessarily require a pelvic exam.

If your doctor recommends a pelvic exam, talk to them about options to make it more comfortable for you. For example, case reports suggest that different leg positions and the use of water-based lubricants may facilitate pelvic exams for some women. If you have been worried about post-coital bleeding, seeing your doctor can help you calm down.

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Cervical and uterine cancer

Vaginal bleeding, including bleeding after having sex, can be a symptom of cervical and uterine cancer. These cancers are more common in women over 50 or in women who have experienced menopause.

In addition to age, other risk factors include a family history of one of these cancers, being overweight (for endometrial cancer) or taking birth control pills for five years or more (for cervical cancer). Being infected with the human papilloma virus (HPV) is another risk factor for cervical cancer.

If you experience postcoital bleeding and have gone through menopause, consult your doctor to identify or rule out cervical and uterine cancers. As with other types of cancer, treatment is most effective when cancer is detected and treated early.


Severe complications of postcoital bleeding are not common, unless the cause is cancer or an untreated infection. Below are some possible complications.


Heavy or prolonged bleeding can cause iron deficiency anemia because the red blood cells in your body become depleted due to the loss of blood. Signs of anemia include:

  • fatigue

  • weakness

  • dizziness

  • Headaches

  • unusually pale skin

If your anemia is caused by the loss of blood, your doctor may prescribe an iron supplement. But the most important source of iron is diet. If you are concerned about your iron levels, add more of these iron-rich foods to your diet:


If you have vaginal dryness, you have a higher risk of getting a urinary tract infection.

Identifying the cause

Bleeding after sex is commonly caused by vaginal dryness, but there are also other, more serious causes. Postcoital bleeding can be a symptom of many conditions. Your doctor will first rule out cancer by examining your vagina and cervix, performing a Pap test, and possibly performing a biopsy. If cancer is found, it will be referred to a specialist.

After removing the cancer as the cause of your bleeding, several steps can be taken to determine the source:

  • Examination of your vagina and cervix, either visually or through an augmentation device called a colposcope

  • transvaginal ultrasound

  • urine test

  • blood test

  • test of your vaginal discharge

Treatment of postcoital bleeding

The cause of your vaginal bleeding will determine your treatment.


If your bleeding is caused by vaginal dryness, vaginal moisturizers can help. Applied regularly, these products are absorbed by the walls of the vagina. They increase moisture and help restore the natural acidity of the vagina.

Vaginal lubricants also reduce uncomfortable friction during intercourse. You may want to avoid products that contain parabens or propylene glycol. Find some water and silicone based lubricants online now.


  • Petroleum-based lubricants, such as petroleum jelly, can damage latex condoms and diaphragms. Do not mix petroleum jelly and condoms. Use a lubricant that contains water or silicone if this worries you.

Estrogen therapy

If your vaginal dryness is caused by menopause or removal of the ovaries, talk to your doctor about estrogen therapy. Topical estrogen products include vaginal estrogen creams and suppositories. Another option is an estrogen ring. This is a flexible ring that is inserted into the vagina. Releases a low dose of estrogen for 90 days.

Oral hormone therapy, which replaces the hormones estrogen and progestin, is another option for some women. Talk to your doctor about the risks and benefits of this treatment.

Additional treatments

Vaginitis can be caused by infection or vaginal dryness. The cause may also be unknown. Depending on the cause, your doctor may prescribe an antibiotic.

Antibiotics may also be prescribed to treat pelvic inflammatory disease and sexually transmitted diseases.

If your cervix has been damaged by an infection, your doctor can remove the affected cells using silver nitrate or cryosurgery. In this process, the damaged cells are frozen and dead.

Prevention of bleeding after sex.

Determining how to prevent postcoital bleeding depends on what caused bleeding in the past. For most women, the use of water-based or silicone-based lubricants will help prevent bleeding caused by vaginal dryness and friction during sex. If you are using condoms, an oil-based lubricant can damage it. Water-based lubricants are recommended.

It can also help you have sex slowly and stop if you feel pain. Using vaginal moisturizers regularly can help keep the area moist and make you feel comfortable.

If your symptoms of postcoital bleeding are related to a medical condition, you can talk with your doctor about the best options to prevent future episodes. Be careful to follow the treatment plan recommended by your doctor.


Bleeding after having sex is usually a symptom of another condition. Many of these, such as infections and polyps, are treatable. Occasional spots after sex usually go away on their own without medical attention. If you are postmenopausal, notify your doctor immediately of any postcoital bleeding.

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