If you notice you are bleeding either during or after intercourse, it is time to make an appointment to see your gynecologist. There are several possible causes and it is important for your doctor to determine what the reason is for the bleeding and make sure you receive the appropriate treatment. Some of the most common causes for bleeding during sex are:
Cervical Erosion or Cervical Ectropion - Although this sounds pretty bad, this is a benign condition caused by an inflammation on the neck of the uterus where the lining of the cervical canal extends into the opening of the cervix. Because the cervical cells are inflamed friction from sex can cause them to bleed. This is more common in younger women , during pregnancy or in those taking birth control because of higher estrogen levels.
Sexually Transmitted Diseases - Some STDs can cause bleeding during or after intercourse. Gonorrhea, chlamydia and trichomoniasis all affect cervical cells and can also cause vaginal discharge. Left untreated, STDs can cause infertility.
Abnormal Growths on the Cervix - Precancerous or cancerous growths can cause bleeding and should be checked immediately by a doctor. There are also non-cancerous growths, such as polyps, which can cause bleeding. Some polyps go away on their own and some require surgery to be removed.
Endometriosis - This includes endometritis, which is an inflammation of the lining of the uterus and adenomyosis, which is when endometrial tissue grows outside the uterus. Both can cause bleeding or spotting.
Injury to the Vaginal Wall - Dryness during sex can cause scratches or tears which can cause bleeding. Using lubricants during sex helps. Low estrogen levels in peri- and post-menopausal women can cause thinning of the vaginal wall which can make it more susceptible to tears or infection.
Fibroid Tumors - Fibroid tumors are masses of fibrous tissue which grow in the uterus. They are normally benign and shrink once a woman hits menopause. Estrogen increases the growth of fibroid tumors. Many women never have any symptoms or require any treatment.
Yeast Infection - Yeast infections can sometimes cause bleeding. More common symptoms are itching or burning and a white, odorless cheese-like discharge.
Because there are several different causes, it is important to see your doctor as soon as possible. An exam can rule out some of the above causes. For others a biopsy and pap smear may be necessary. Obviously, treatment would depend on the underlining cause for the bleeding. STDs are treated with antibiotics, while tears in the vaginal wall may simply need time to heal.
“Bleeding After Sex.” cancerhelp.org. 12 Feb. 2008. CancerHelp UK.
“Endometriosis: What is Endometriosis?” nih.gov. 16 Feb. 2007. National Institutes of Health.
“What Can Cause Bleeding During Sex,” 2010, July 5, Dr. Jennifer Shu, CNN.com
“What Causes Bleeding After Sex?” nhs.uk. 27 Nov. 2008. National Health Service.
Eileen Bailey is a freelance health writer. She is the author of What Went Right: Reframe Your Thinking for a Happier Now, Idiot’s Guide to Adult ADHD, Idiot’s Guide to Cognitive Behavioral Therapy, Essential Guide to Overcoming Obsessive Love, and Essential Guide to Asperger’s Syndrome. She can be found on Twitter @eileenmbailey and on Facebook at eileenmbailey.