Bleeding During Sex: What does it Mean?

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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.

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“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.

What does it mean when you bleed during sex? This is very common for women that are regularly menstruating and more common in women past menopause. 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.

Also, the reasons for bleeding during sex and after sex (postcoital bleeding) tend to overlap. If the bleeding is a recurring issue, it’s always best to seek medical advice about your sexual health from your Ob / GYN.

Menopause and Hormones

It is more common for women who have reached menopause to bleed often during or after having sex. This is because as you age, your body will tend to produce less of the estrogen hormones. Lower estrogen levels, lead to thinning walls, and lower production of cervical mucus. Thus, it becomes easier for vaginal tearing, especially during rough sex. This condition is known as Atrophic Vaginitis, which can also cause itching and burning sensations in the vagina.

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Cancer in Reproductive Organs

Cancer in the reproductive organs is a much less likely cause of your bleeding; Nevertheless, vaginal bleeding is one of the symptoms of cervicaluterine, and vaginal cancer.

The type of tumor depends on the type of cancer a person contracts. Tumors are built up of solid, improperly developed blood vessels, when the tumors grow, these fragile blood developed blood vessels over dilate (stretch) and are more susceptible to bursting. Sex can aggravate blood vessel bursting. 

Excluding sexual intercourse, vaginal bleeding is a more relatively common symptom of cervical cancer. Bleeding symptoms of cervical cancer include:

  • Bleeding between periods or post-menopause
  • Heavy and long periods
  • Vaginal Discharge mixed with blood

If going to a gynecologist to be evaluated for cervical cancer, expect a Pap smear, pelvic exam, and a visual checkup(colonoscopy). An Ob / GYN that is suspicious of cancer may examine a sample of your body tissue through.

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Sexual and Physical Trauma

Often times bleeding during sex is related to infections and abnormal functions in your reproductive organs. Bleeding can simply be the result of physical trauma. You may be having overly rough sex, which can tear vaginal tissue. Tearing during sex is more likely to occur because of vaginal dryness, which can happen due to menopause, breastfeeding, and unsafe vaginal cleaning (douching). 

On a more serious matter, vaginal bleeding can be the product of sexual abuse. Victims of forced entry can risk vaginal tears that need to be medically treated.

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.

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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.

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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).

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