Postcoital Bleeding: What Causes Bleeding After Sex

Bleeding after sex, known as postcoital bleeding, may be a sign of a minor issue such as vaginal dryness or a more serious condition that you should discuss with your healthcare provider.

Postcoital bleeding is not related to your menstrual cycle. Rather, blood flows from the lining of the vagina or cervix. Depending on the cause, blood may be bright red or darker, and it may be a trace amount or a heavy, sheet-soaking puddle.

This article will go over the causes of postcoital bleeding. You will learn which conditions can have postcoital bleeding as a symptom and when bleeding after sex needs medical treatment.

Causes of cervical bleeding after sex
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Postcoital Bleeding Symptoms

Postcoital bleeding happens after sex that involves vaginal penetration—for example, by a penis, dildo, or a partner’s finger.

Postcoital bleeding usually does not hurt. Only about 15% of people who experience bleeding after sex also report feeling pain with sex (dyspareunia).

If you're bleeding after sex, you may also have abnormal uterine bleeding that is not related to sexual intercourse. About 30% of people with postcoital bleeding also have episodes of bleeding that occur outside of their regular monthly period. 

If you're having postcoital bleeding, it's important to tell your healthcare provider—especially if you're also having pain with sex or after sex.

Vaginal Causes of Bleeding After Sex

Vaginal bleeding after sex is usually caused by direct trauma to the wall of your vagina. This is called a vaginal laceration.

The vagina does not usually tear with intercourse, but it can happen if the vagina is not well lubricated beforehand—either from natural secretions or a store-bought lubricant.

For example, as people get older, the tissue of the vagina can become thinner and more sensitive (atrophic vaginitis), which can make tearing during intercourse more likely.

The vaginal wall may also tear if:

  • Your estrogen levels are low (e.g., during breastfeeding and menopause)
  • You've had unusually rough sex
  • A foreign object was used for vaginal penetration (e.g., genital piercings or implants)

A vaginal laceration can also happen during childbirth. In either case, the vagina will heal—but it takes time.

With this type of postcoital bleeding, the blood is usually bright red and heavy. A minor vagina laceration might only bleed a short time and then stop, though the pain can last for up to two weeks. In more severe cases, stitches might be needed. After about six weeks, the tear should be fully healed.

A vaginal tear that does not need stitches heals in about two weeks. A tear that does need stitches should heal in about six weeks.

Cervical Causes of Bleeding After Sex

Unlike bleeding from the vagina, bleeding from the cervix after sex is usually only a small amount of blood. In fact, it can be so scant that you may notice it only after wiping yourself during a bathroom break.

There are four reasons why your cervix may bleed after sex.

Cervical Ectropion

The cervix is the passageway between the vagina and uterus. The outside of the cervix has the same type of cells as the vagina, but the inside (canal) of the cervix has a different type of cell.

The cells covering the cervix act as a barrier. They are resistant to the vaginal environment, which includes the friction of intercourse. However, the cells that line the canal of the cervix are much more fragile.

Cervical ectropion is a condition in which the canal of the cervix is turned inside out, exposing the more fragile cells. Pregnancy and birth control pill use can be associated with these changes.

These cells bleed very easily when touched, even lightly. If you have cervical ectropion, it is more likely you will have postcoital bleeding.

Cervical Polyps

The cells that line the canal of the cervix can make growths called polyps. Endocervical polyps are usually not serious (benign). However, they have a rich blood supply and can bleed easily.

The polyps form in the canal of your cervix. As they grow, they stick out of the end of your cervix, where they can be irritated and bleed during sex.

Cervicitis

Inflammation of the cervix (cervicitis) can also cause bleeding after sex. The sexually transmitted infection (STI) chlamydia is the most common cause of acute cervicitis.

In the early stages, a chlamydia infection has no symptoms. However, it is a serious infection that can affect fertility. As long as it's diagnosed, chlamydia can be treated with antibiotics.

Cervical Cancer

Cervical cancer is the most serious cause of postcoital bleeding. However, it's also a very uncommon reason for bleeding after sex.

Cervical cancer is even less likely to be the cause of postcoital bleeding if you regularly see your healthcare provider for regular cervical cancer screenings.

If you're looking up reasons for bleeding after sex on the Internet and see that cervical cancer is a possibility, don't panic. There are other causes of postcoital bleeding that are more likely. However, to know for sure and put your mind at ease, it's a good idea to see your provider if you're bleeding after sex.

Other Causes of Bleeding After Sex

There are also other causes of postcoital bleeding that can involve the vagina, cervix, or both. For example, sexually transmitted infections (STIs) and pelvic inflammatory disease (PID) can both cause bleeding after sex.

Postcoital bleeding may happen if someone has another reproductive condition like a prolapsed uterus or reproductive cancers like endometrial (uterine) or vaginal cancer.

It's also possible that a person will bleed after sex if they are on their period. However, the bleeding is from their normal menstrual cycle or is spotting rather than true postcoital bleeding.

Postcoital Bleeding Diagnosis

To figure out what is causing you to bleed after sex, your provider may ask you the following questions:

  • Do you have a new sex partner?
  • When did the bleeding start?
  • Do you practice safe sex?
  • Do you use any sex toys or other foreign objects during sex?
  • Do you have pain with sex?
  • Do you always bleed after sex or only at certain times of the month or in certain positions?
  • Do you have bleeding outside of your regular period that is not related to sex?

If you feel awkward or uncomfortable talking about sex with your provider, remember that they are there to help. Most providers discuss these topics with patients regularly and are nonjudgmental.

Summary

Bleeding after sex comes from one of two places: the vagina or the cervix. The amount of blood can vary—from a large amount of vaginal blood to a scant amount from the cervix.

Conditions like cervical ectropion, polyps, cervicitis, or cervical cancer can cause postcoital bleeding. Tears in the delicate tissues of the vagina can also cause bleeding after sex.

If you are having postcoital bleeding, don't panic. Make an appointment with your provider to find out what the cause is.

Frequently Asked Questions

  • How long does postcoital bleeding last?

    Bleeding after sex can be so brief that you barely notice it or it can last for a few days.

  • Can you use a tampon for after-sex bleeding?

    Bleeding after sex should not be heavy enough to require a tampon. If you are bleeding that heavily, it could be one of two things: Your period may have started or you may have an injury that requires medical attention.

  • How do you stop bleeding after sex?

    Postcoital bleeding will usually stop on its own unless it's from an injury that needs stitches. That said, you should talk to your provider if you are having bleeding after sex, as they can let you know if it needs treatment.

  • Is there anything that can be done at home to ease vaginal tear discomfort?

    Take an over-the-counter (OTC) pain reliever as needed, take a sitz bath at least once a day, and avoid touching the torn area while it heals.

5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Austin JM, Cooksey CM, Minikel LL, Zaritsky EF. Postcoital vaginal rupture in a young woman with no prior pelvic surgery. J Sex Med. 2013;10(8):2121-4. doi:10.1111/j.1743-6109.2012.02682.x

  3. Fairview Health Services. Vaginal Tear (Non-Obstetric).

  4. MyHealth Alberta. Perineal Tear: What to Expect at Home.

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By Andrea Chisholm, MD
Andrea Chisolm, MD, is a board-certified OB/GYN who has taught at both Tufts University School of Medicine and Harvard Medical School.