Bleeding After Sex: Everything You Need To Know

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​​Dr. Ghazal is a double board certified fertility specialist, a Southern California native and an award-winning top doctor.
Sanaz Ghazal, M.D., F.A.C.O.G. Fertility / Reproductive Health / Obstetrics and Gynecology
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It can be unsettling to experience vaginal bleeding after sex—and even more so if you’re pregnant or planning to become pregnant. There are a variety of reasons why you might have some bleeding after sex. Sometimes, it could be as simple as not using enough lubricant during sex. Other times, it could signal an abnormality with your cervical health and may warrant a more in-depth check-in with your doctor.

Read on for what OB-GYNs have to say about bleeding after sex and how to treat and prevent it.

How Common Is Bleeding After Sex?

It’s natural to wonder: Is bleeding after sex normal, or am I the only one experiencing it? “Bleeding after sex is not uncommon, but we should all pay attention to it,” says Mary Jane Minkin, M.D., a clinical professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at the Yale School of Medicine in New Haven, Connecticut.

It affects up to 9% of people at some point during their menstrual years[1]. And in about half of these instances, the bleeding resolves on its own without any kind of medical intervention.

Vaginal dryness, which can result from many different hormonal scenarios (including menopause) is one of the more common causes of bleeding after sex, according to Dr. Minkin.

There’s also a chance that the bleeding, especially if it’s light, could just be your period—whether it’s right before or right after your expected period.

In the case that it’s not your period, here’s what else may cause postcoital bleeding.

What Causes Bleeding After Sex?

Hormonal Vaginal Dryness

Most of the time, when the vagina and cervix are dry, the culprit is a lack of the hormone estrogen, which boosts natural lubrication, explains Dr. Minkin. Low estrogen can often occur during the perimenopausal (pre-menopause), menopausal and post-menopausal periods, during which estrogen naturally drops. If you’re breastfeeding, you’re also likely in a low-estrogen state and might have vaginal dryness that can lead to bleeding after sex from too much friction and small tears in the vaginal tissue. The same goes for anyone on hormonal birth control. “People who are on a very low dose (low estrogen) oral contraceptive can have bleeding, too,” says Dr. Minkin.

One way to combat vaginal dryness proactively is use a vaginal moisturizer like Replens Long-Lasting Vaginal Moisturizer, Dr. Minkin says. It’s also important to use plenty of lubricant during sex to prevent tearing and excess friction, adds Kate Balestrieri, Ph.D., a licensed psychologist, sex therapist and founder of the therapy provider Modern Intimacy. Don’t be afraid to reapply multiple times in a night.

Vaginal Tearing

If you’re noticing light bleeding after sex, it might be the result of rougher sex that causes accidental trauma to the vaginal tissue, such as slight tearing, says Monique Rainford, M.D., assistant professor of obstetrics, gynecology and reproductive sciences at Yale University School of Medicine. On the other hand, it’s also common in cases of abuse or sexual assault for someone to experience physical trauma in the form of vaginal tearing.

Keep tabs on the amount of bleeding you’re noticing. “Both light and heavy bleeding should be evaluated, but the urgency of the evaluation depends on the amount of bleeding,” says Dr. Rainford. If you experience heavy bleeding after sex, it could be a sign of a vaginal laceration and definitely would require a call to your doctor’s office and timely treatment.

Something that may help keep you more comfortable and avoid bleeding during consensual sex is clear communication with your partner, especially if anything feels painful. Consider using a safe word or gesture to signal to your partner that it’s time to stop or switch positions, suggests Dr. Balestrieri. You also might benefit from a longer warm-up to sex. “Engage in more foreplay (outercourse) before beginning intercourse to ensure your body is ready for vigorous movements and to reduce injury to the vulva or vagina,” says Balestrieri.

Vaginal Infections

Research from the University of Rochester Medical Center suggests 30% of people with vulvas experience vaginitis—an irritation or infection of the vagina—at some point in their lives[2]. That irritation of the tissue, regardless of what’s causing it, might also lead to bleeding after sex.

“A bad yeast infection can lead to bleeding from both the cervix and the vagina,” says Dr. Minkin. Doctors often advise waiting until yeast infection symptoms clear to engage in vaginal sex.

Certain sexually transmitted infections (STIs), including chlamydia, gonorrhea and genital herpes, might also result in some bleeding during or after sex.

Always practice safe sex (meaning with at least one partner using some kind of barrier protection) to reduce your likelihood of infection and therefore bleeding, recommends Balestrieri. Also keep up with regular testing for STIs so you know your status and can seek proper treatment for any infections.

Pregnancy

If you’re pregnant, bleeding after sex can understandably give you more pause. Just know that light bleeding occurs in up to 25 of every 100 pregnancies in the first trimester, according to the American College of Obstetricians and Gynecologists (ACOG)[3]. In the first few days of your first trimester, even before your missed period, you may see some implantation bleeding, a light spotting due to the fertilized egg attaching to the uterine lining. Light bleeding also could result from having sex while you’re pregnant, as pregnancy causes the cervix to soften, which can cause bleeding if you bump the cervix during sex, says Dr. Minkin.

That spotting could be from other changes in your body, too, such as the placenta hanging lower in the uterus. “Your provider will probably want to get an ultrasound to check to see if the placenta is coming down before the baby, and if that’s the case, they will want you to hold off having sex until the placenta climbs up the wall of the uterus,” says Dr. Minkin. It’s possible the situation will resolve itself naturally, she adds, but it’s worth running it by your doctor to make sure everything’s okay.

Cervical Growths or Abnormalities

Any kind of growths, including cervical polyps— which are often benign (non-cancerous) growths on the cervix— can make you more prone to bleeding after sex, says Dr. Rainford.

There are also normal variants in the cervix, including cervical ectropion, which is an outward inversion of the cervix that causes the tissue to become red and sensitive.

Additionally, a precancerous lesion or spot of cervical cancer can be the most worrisome cause of bleeding after sex, says Dr. Minkin.

However, if you see your OB-GYN regularly and get routine pap smears, you’re getting the necessary proactive care.

Your Safety Is Important

If you are a survivor of sexual assault and need support, call 800.656.HOPE (4673) to be connected with a trained staff member from a sexual assault service provider in your area.

When to See a Doctor

Now that you’re aware of the many potential causes of bleeding after sex, you might be able to figure out where the light bleeding is coming from on your own—perhaps you started a new birth control pill and it’s causing dryness. However, it’s still valid to bring it up to your health care provider to evaluate, says Dr. Rainford.

If you’re having repetitive bleeding after sex and are concerned, book an appointment with your OB-GYN as soon as possible so they can examine your cervix and conduct a pap smear, adds Dr. Minkin. But more often than not, occasional light bleeding after sex is not a sign of something serious or wrong. “Do not panic, but check in with your provider, and do get the source of the bleeding evaluated,” says Dr. Minkin.

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