'There are a variety of causes for bleeding after sex,' says Dr Ian Currie, consultant gynaecologist at BMI The Chiltern Hospital. 'If you have repeated bleeding over a number of weeks, you’re pregnant or if you’re in any other way concerned, seek advice from your GP or a sexual health clinic.'
Whether you typically experience bleeding during sex, bleeding after sex or a bit of both, the causes are usually very similar.
'The colour and amount of bleeding can be very helpful in assessing where it has come from,' says Doctify’s consultant gynaecologist, Dr Anne Henderson. 'Bright red bleeding, which becomes visible immediately after intercourse, is more likely to be related to a cervical problem. This type of bleeding is usually self-limiting and rarely last longer than a few hours. Where bleeding lasts for up to 12-24 hours, or is a brownish colour, it is more likely to be associated with bleeding from the womb lining.'
FYI, spotting between periods is another issue altogether. Scroll on to find out what’s causing sex-related bleeding for you.
1/ You've got an undiagnosed STI
Sorry to break to you, but bleeding after intercourse is a key example of STI symptoms in women. Think chlamydia and gonorrhoea, for starters. 'The inflammation of your cervix causes the blood vessels there to swell,' Currie says. Meaning? Every time you start to grind, they’re more prone to being burst.
2/ You've got polyps on your cervix
The good news is that these lesions, although they have the annoying habit of bleeding, are usually not cancerous and can easily be removed by your doctor.
'When bleeding arises from the cervix, the most common causes are benign,' says Dr Henderson. 'Polyps can be treated in outpatients by minor surgery.'
3/ You're not wet enough
This one makes total sense. Dryness plus excessive friction equals staining of the sheets. Vaginal dryness can occur for a number of reasons. It could be one of other menopause symptoms that can occur at any age. Or it could be that you are not suitably aroused. 'If sex feels uncomfortable, additional lubrication can really help,' Currie says.
Opt for something especially formulated to be moisturising like those from Sylk.
4/ You've got an infection
Not only can STIs cause bleeding during sex, infections such as pelvic inflammatory disease (PID) can, too.
Although this can be caused by chlamydia and gonorrhoea, it can also be the result of normally harmless bacteria, found in the vagina, getting past the cervix and into the reproductive organs.
This is most likely to happen if you’ve had PID before, experienced damage to the cervix following childbirth or miscarriage, or have had a medical procedure that involved opening the cervix such as an abortion. PID can be treated with antibiotics; left undiagnosed, it can negatively affect fertility.
5/ You're experiencing an ectropion bleed
It may sound scary but ectropion bleeds – also known as cervical erosion – is a real women’s health condition. 'It occurs more commonly in young women,' says Currie.
'This is because the area of fine blood vessels at the entrance of the cervix is more easily agitated. As you age, this area of cells moves to be within the cervix.' Ever experienced bleeding after a smear test?
This is why. It’s nothing to worry about if it’s a one-off and your smear comes back clear but, if it occurs regularly, it shouldn’t be ignored. 'You can cauterise the cells that are causing the issue, which is a simple outpatient procedure,' Currie says.
6/ You've got endometriosis
Endometriosis is where cells, like the ones in the lining of the womb, are found elsewhere in the body and yes, if these cells deposit on the cervix or within the vagina, it can trigger bleeding after sex. It is, however, rare.
'The commonest symptoms that endometriosis causes are pelvic pain, particularly related to periods and intercourse; and bowel-related pain and bleeding,' says Dr Henderson.
7/ You're having a breakthrough bleed
'Some women experience breakthrough bleeding while they are on the pill and coincidentally this can happen while they are having sex,' says Currie.
'The intercourse itself is not causing the bleed but the motion may prompt it to happen.'
8/ You've just had a baby
With all the tearing that goes on during the most wonderful experience of a woman’s life… it’s no wonder that bleeding during sex might arise if you’ve not long giving birth. However, it can also be that hormonal changes are playing their part.
'Hormonal changes during pregnancy cause the lining of the cervical canal to protrude down onto the main body of the cervix,” says Dr Henderson. 'This can be disrupted by intercourse.'
9/ You've got cervical cancer
Okay, so it’s not a common reason but, that said, it’s always important to be on the alert for symptoms of vaginal, uterine and cervical cancer.
'More persistent or heavier bleeding may indicate pre-cancerous or cancerous changes,' says Dr Henderson. 'This will be extremely rare, though, if you regularly attend your smear test.'
This article originally appeared on Women's Health UK.
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