Postcoital Bleeding: Should You Be Concerned?

Experts say that postcoital bleeding is a condition that can point to various issues, from vaginal dryness to serious diagnoses, which need to be discussed and monitored by your chosen doctor. 

As it is evident, bleeding after sex is not related to the menstrual cycle because the flow of blood in this situation comes from either the cervix or from the lining of the vagina, depending on the exact cause of the bleeding.  

Although it is scary to see bloody traces after sexual intercourse, it is very common, and it occurs in almost 10% of women who still have an active menstrual cycle. As mentioned, the reasons can vary, stretching from a particular infection to cervical cancer. 

Dr. David Ellman from the Women’s Healthcare of Boca Raton clinic is an expert in this field. Treating conditions like this demands a proper diagnosis of the cause. Having an expert as your chosen doctor will help you elevate the symptoms and have successful results during the treatment.  

What Are the Causes of Postcoital Bleeding?

The causes of bleeding after sex can be connected either to the vagina or the cervix. Below you can find a variety of potential reasons, so you can eliminate your doubts and potentially find the actual cause of your condition. Please do not make any diagnosis by yourself; call your doctor and schedule an appointment. 

When it comes to causes that derive from the cervix, i.e., the narrow tunnel-like end of the womb, which opens into the vagina, the most popular ones are cervical inflammation or cervicitis and cervical polyps. Cervicitis can be either harmless or a symptom of an STI, such as gonorrhea or chlamydia. On the other hand, cervical polyps are small growths that are mostly not malign and can be removed by a doctor during a regular appointment, but they are rich in blood and can bleed very easily. 

Cervical ectropion is another condition that can cause bleeding after sex. This condition implies that the cervix is turned inside out and because the cells inside the cervical canal are very fragile, the exposure of those cells leads to bleeding. A person with cervical ectropion will likely experience bleeding after sexual intercourse because the cells within the canal bleed easily when in contact with an external factor. 

Cervical cancer can also be a cause of postcoital bleeding, and it is the most severe cause when it comes to this condition. At the same time, it is a highly uncommon reason for bleeding, so if you visit your chosen doctor regularly, there is a great chance you will not have to put cervical cancer on the list of causes for bleeding after sex.

Regarding the amount of blood you might experience during postcoital bleeding, in the case of cervical bleeding, it is just a tiny amount, while uterine bleeding can be on a much larger scale. When the blood originates from the vagina, it is bright red and very heavy. Bleeding can sometimes be followed by pain lasting up to two weeks. 

As mentioned earlier, postcoital bleeding can also have vaginal causes. Bleeding from the vagina is generally caused by vaginal laceration, which is any trauma that occurs on the walls of the vagina. Reasons for this can be vaginal dryness caused by: 

• Childbirth 
• A cold
• Anti-estrogen medication
• Therapy for cancer
• Douching 
• Menopause
• Breastfeeding 

Vaginal tears, which cause bleeding, can also occur when your estrogen levels are low, when the person is practicing rough sex, or when a foreign object, such as a piercing, is present during penetration. 

There are other reasons which can cause bleeding after sex, and they include:

• STIs
• Pelvic inflammatory disease
• Prolapsed uterus 
• Vaginal cancer
• Endometrial cancer 

Whether the cause of the bleeding is simply vaginal dryness, pelvic inflammatory disease, or some type of cancer, when you notice the following symptoms, please contact your doctor and let them give a proper diagnosis:

• Pain after intercourse
• Pain during intercourse 
• Bleeding after intercourse 
• Abnormal uterine bleeding 

Diagnosis of the Condition 

When symptoms start occurring, the first step is to make an appointment with your chosen doctor and give them all the necessary information. The doctor might ask certain questions that might not be comfortable for everyone to answer, but make sure you answer them as accurately as possible to get a proper diagnosis.

The questions might include information about your sex partners, safe sex, using sex toys and foreign objects, pain when the issue started to occur, whether the bleeding often occurs, etc. 

Afterward, the doctor might perform a physical examination, including a pelvic exam, so they have all the necessary data to make an accurate diagnosis and a treatment plan. Additional tests might include a pregnancy test, transvaginal ultrasound, pap test, STIs testing, STDs testing, a cervical exam, colposcopy, etc. 

Whatever the results might be, the medical professional is there to help you elevate the symptoms and resolve the issue at hand. Ensure you follow everything that is advised properly and do not panic; postcoital bleeding is not atypical, it happens to many women, and the treatment options are various. 

Risk Factors 

Certain risk factors might influence how high the chance of you suffering from bleeding after sex. They include:

• Suffering from cancer of the vagina, uterus, or cervix
• Going through the period of menopause or transitioning toward menopause
• Breastfeeding 
• Giving birth shortly before the condition’s development 
• Using products for douching 
• Suffering from an STI or STD
• Having an infection on the cervix
• Low level of arousal before penetration

Treatment Options 

As with many different conditions, the treatment plan depends on the cause of the condition and the severity of the symptoms. When talking about postcoital bleeding, here are some options that have been helpful to patients in the past:

• Moisturizers and lubricants 
• Treatments for sexually transmitted infections (antibiotics)
• Therapy includes low estrogen levels (creams, rings, etc.)
• Medication for viral infections 
• Chemotherapy, radiation, or surgery if the cause is cancer of the cervix
• Removal of polyps 

Can I Prevent Bleeding After Sex?

Some cases of vaginal bleeding after coitus cannot be prevented, but there are precautionary steps you can take to reduce the frequency and gravity of the bleeding. These steps can be:

• Using silicone or water-based lubrication 
• Avoiding aggressive sexual intercourse 
• Using moisturizers for the vagina every day
• Avoiding scented products for intimate use
• Using protection from STIs and STDs such as condoms
• Hydrating your body 
• Having regular check-ups with your gynecologist 

Any Other Questions? 

Postcoital bleeding can be very stressful and uncomfortable. Our clinic is here for you in case you have any additional questions and if you would like to come to a safe space to talk about the issues, you are facing. Call us today and schedule a consultation.