Is it Normal to Bleed after Intercourse?

Vaginal bleeding after sex (postcoital bleeding) isn’t uncommon. Up to 63% of postmenopausal women experience bleeding or spotting due to vaginal dryness, and up to 9% of menstruating women experience the same, though usually from issues with the cervix.

Occasional, light bleeding is rarely dangerous and probably doesn’t need the attention of a doctor. However, if you’re postmenopausal or experience the following symptoms, you should make an appointment right away:

• Vaginal itching or burning
• A burning feeling while urinating
• Painful intercourse
• Severe abdominal or lower back pain
• Nausea or vomiting
• Heavy bleeding
• Unusual vaginal discharge

At the OB/GYN office of Dr. Hany H. Ahmed in Houston, Texas, you’ll find compassionate and comprehensive women’s care. If you’re bothered by vaginal bleeding after intercourse, Dr. Ahmed can diagnose the underlying problem and find an effective treatment. 

Here’s what you need to know:

What causes postcoital bleeding, and what can you do about it?

Perhaps the most common reason for bleeding after sex is menstruation. This might seem obvious, but ask yourself if it’s around that time of the month before you get worried or call the doctor. 

Sex either just before or after your period may cause bleeding, but it’s not considered postcoital bleeding. It’s totally harmless, and there’s no treatment needed.

Other causes include:

Cervicitis

An inflammation or infection of the cervix, this condition can cause bleeding and/or a change in vaginal discharge. Causes of cervicitis include:

• Sexually transmitted diseases (STDs), such as chlamydia
• Trichomoniasis, a sexually transmitted parasitic infection
• Bacterial vaginosis, a bacterial imbalance in the vagina, causing inflammation

The treatment for cervicitis is a course of antibiotics, which should clear up the problem.

Genitourinary syndrome of menopause (GSM)

Previously known as vaginal atrophy, this is common in women going through perimenopause and menopause, as well as those who’ve had their ovaries removed. As you age, your body produces less estrogen, the female hormone that regulates your reproductive system.

With lower estrogen levels, the vagina produces less lubrication, often becoming dry and inflamed. Lower estrogen levels also reduce vaginal elasticity; the tissues become thinner and shrink. This may lead to pain and bleeding during sex.

To combat the problem, you can try using an over-the-counter lubricant during sex. In addition,  we may prescribe hormone replacement therapy, in pill or cream form, or as a vaginal insert.

Polyps

These benign growths can be found on the cervix or in the endometrial lining of the uterus, sometimes the result of chronic inflammation or hormonal changes. Their movement may irritate the surrounding tissue, causing bleeding from small blood vessels.

If you have just minor symptoms, you may not require treatment. If Dr. Ahmed opts to remove the polyps, it’s because there’s a small chance of abnormal cells associated with irregular bleeding. He sends the tissue to a lab for evaluation to confirm that the growths are benign.

Fibroids

Fibroids are benign but abnormal growths of muscle tissue in or on the uterine walls. They’re most common during a woman’s reproductive years, occur most often in women of African ancestry, and affect about 3 in 4 women at some point during their lives. 

They may produce no symptoms at all or cause problems such as irregular vaginal bleeding and pelvic pain. Fibroids are treated with:

• Medications, usually hormonal medications
• Lifestyle changes, including weight loss, dietary changes, and exercise
• Nonsurgical procedures, such as endometrial ablation, to cut off blood supply

Surgery, if necessary, ranges from the minimally invasive to a hysterectomy in severe cases.

Cervical cancer

Irregular vaginal bleeding, including postcoital bleeding, may indicate the presence of cervical or vaginal cancer — 11% of women diagnosed with cervical cancer reported this as their first symptom of the condition.

If Dr. Ahmed diagnoses you with cervical cancer, he refers you to a gynecologic oncologist. If the oncologist finds precancerous cells, they can perform a simple outpatient procedure to remove the abnormal cells. If the cells are cancerous, some combination of chemotherapy, radiation, and surgery is likely.

Bleeding after intercourse may be nothing, or it may be a sign of something that needs attention. Your best bet is to contact Dr. Ahmed so he can evaluate your situation and recommend any necessary treatment. 

Give the office a call at 713-489-3348, or book your consultation online today. We make it our business to protect your health and peace of mind.