If you notice spots of blood during or after intercourse (or sex), it can be worrisome. Did you miscalculate your period? Is something wrong? Is this normal?
“Bleeding is not common during or after sex, but it isn’t necessarily a cause for concern,” said Terry Groff, MD, an OBGYN with Banner Health.
Most of the time, bleeding during or after sex (also called postcoital bleeding) isn’t a big deal, especially if it only happens once or twice. But if bleeding happens regularly, it can be a sign of a problem that your health care provider should address.
Dr. Groff helps explain potential reasons for bleeding during and after sex and what to do if you’re worried.
Common causes of bleeding during and after sex
1. Vaginal dryness
Vaginal dryness usually happens when there isn’t enough natural lubrication in the vagina.
If you have vaginal dryness, you may find sex less enjoyable and even painful. Sometimes, vaginal dryness may cause bleeding, as constant friction (rubbing) during sex can cause vaginal wall tissue to break open.
“Vaginal dryness can be more common in people who haven’t had enough genital stimulation or are going through menopause,” Dr. Groff said. It can also occur in people undergoing chemotherapy.
The good news is that you can combat vaginal dryness by restoring moisture to your vagina. Your health care provider can discuss options, including lubricants, moisturizers and vaginal estrogen.
2. Early pregnancy
If you’re pregnant and notice some light bleeding, don’t panic!
“Bleeding during early pregnancy is always very scary because of its relationship to miscarriage, but light bleeding in early pregnancy is very common,” Dr. Groff said.
One of the most common causes of bleeding in early pregnancy occurs in the first few weeks during implantation when the fertilized egg attaches to the wall of the uterus. It is not uncommon to notice spotting or light bleeding after sex.
Not all spotting and bleeding are causes for concern in pregnancy, but you should let your health care provider know when it happens.
3. Postpartum bleeding
It’s normal to experience some bleeding in the weeks that follow childbirth. Dr. Groff mentions that this bleeding can last up to six weeks but gradually improves.
After having a baby, your body needs some time off. Wait to have sex until your health care provider has given you the all-clear to resume sexual activities.
Once you’re given the green light, try to take things slow and ease back into sex. If you experience any pain or other symptoms, talk to your provider.
Here are some tips regarding intimacy and sex after a vaginal delivery.
4. Birth control
Spotting between periods, or breakthrough bleeding, can happen when you start a new hormonal birth control. It’s even more common if you’re on low-dose or ultra-low-dose birth control pills or have an IUD (intrauterine hormonal device) or an implant.
In addition, some people may also experience vaginal dryness, which can cause irritation and some bleeding after sex.
Talk to your health care provider if you think your birth control is causing spotting, bleeding or vaginal dryness, so they can work with you to find alternative birth control methods.
5. Sexually transmitted infections
Sexually transmitted infections (STIs) such as chlamydia and gonorrhea can infect the cervix. This can irritate your cervix and cause it to bleed more readily.
STIs can also lead to pelvic inflammatory disease, an infection of the reproductive organs that may cause bleeding and pelvic pain. Untreated PID can lead to scar tissue and infertility.
If you haven’t been tested recently for STIs, it’s best to get checked out. Most STIs are curable or treatable with antibiotics. The sooner you test and treat, the better.
6. Infections and medical conditions
While not as common, infections and certain medical conditions can also lead to vaginal bleeding:
- Yeast or bacterial infections can cause tissues of the vagina and cervix to become more delicate and more prone to tears and bleeding.
- Endometriosis can be painful and cause heavy periods and bleeding in between periods.
- Uterine and cervical polyps are non-cancerous growths that bleed easily if bumped during sex.
- Cervical and endometrial cancer can also cause bleeding.
Talk to your health care provider so they can examine you and rule out possible causes for your bleeding.
Don’t skip a trip to your provider
If you are experiencing postcoital (after sex) bleeding, Dr. Groff offers some important advice on when to reach out to your health care provider:
- Regular occurrence: If bleeding during sex happens frequently and isn’t related to your period.
- Heavy bleeding: If the bleeding is heavy or soaks through several pads or tampons.
- Menopausal bleeding: If you’ve gone through menopause and experienced vaginal bleeding, it’s essential to see your provider even if the bleeding stops.
- Painful sex: If you experience pain during sex, along with bleeding.
- Other symptoms: If bleeding is accompanied by unusual discharge, pain, discomfort or changes in your menstrual cycle.
Bleeding during or after sex might cause you concern but remember it’s uncommon. Understanding the possible causes and knowing when to seek medical help can help you stay informed and make the right decisions for your health.
If you have questions, don’t hesitate to contact your health care provider or find a Banner Health specialist near you.