Vaginal Bleeding During or After Sex

Causes Range From Trauma or Infection to Cancer

Bleeding during or after sex can be distressing, especially if you're not expecting it. The good news is that in most cases, it's not a sign of a serious health issue.

As many as 9% of menstruating females will experience vaginal bleeding after sex that's unrelated to their period. This is known as postcoital bleeding.

And between 46% and 63% of postmenopausal women will experience dryness, itching, tenderness, or bleeding during or after sex due to hormonal changes that affect the vaginal tissues.

This article explores seven possible explanations for why a woman may bleed during or after sex. Most are not serious or cause for alarm. But you should see your healthcare provider to trace the cause.

Why Do Some Women Bleed During or After Sex?

Verywell / Joshua Seong  

Sexually Transmitted Infections

Sexually transmitted infections (STIs) like chlamydia and gonorrhea are associated with vaginal symptoms that include pelvic pain, itching, burning, vaginal discharge, and frequent, painful urination.

Each type of infection has its own symptoms, and inflammation caused by any of these STIs can cause bleeding.

Trichomoniasis is a type of STI caused by a single-celled parasite. Cervical discharge and cervical bleeding are two of the most common characteristics of the disease.

Syphilis and genital herpes can cause open sores that are prone to bleeding if irritated. While the sores often appear externally, they can sometimes develop inside the vagina. They can be painless and unnoticed until they bleed.

Benign Polyps

Benign growths on the cervix (called cervical polyps) or uterus (uterine or endometrial polyps) are common causes of bleeding during or after sex.

  • Cervical polyps tend to develop in females in their 40s and 50s who have had multiple pregnancies. The polyps are typically red or violet with a tube-like structure that's rich in capillaries and can bleed easily when touched.
  • Uterine polyps are small, soft lumps of tissue protruding from within the uterus. They are prone to bleeding between periods, during sex, and after menopause. They tend to develop in females between the ages of 36 and 55.

The majority of polyps are benign, but some can develop into cancer over time. Polyps will sometimes disappear by themselves. But surgical removal is needed in some cases.

Other noncancerous growths of the genital tract, such as a hemangioma (a tumor made up of blood vessels), can also lead to postcoital bleeding. These growths are far less common causes of bleeding during or after sex.

Cervical Ectropion

Cervical ectropion is a noncancerous condition where the cells that normally line the inside of the cervix protrude outside through the cervical os (the opening of the cervix).

This can cause the already-fragile blood vessels in the cervix to dilate and become inflamed. As a result, bleeding is common with intercourse, the use of tampons, and the insertion of a speculum during a pelvic exam.

Cervical ectropion can occur in adolescents, females taking birth control pills, and pregnant females whose cervixes are softer than normal. It usually does not require treatment unless there is excessive vaginal discharge or bleeding.

Atrophic Vaginitis

Postmenopausal females will often bleed during or after sex because their decreasing estrogen levels cause the vaginal walls to thin and produce less lubricating mucus. This is referred to as atrophic vaginitis, a condition that is associated with vaginal itching and burning.

Vaginal lubricants can often ease dryness and decrease pain. Atrophic vaginitis can be treated with estrogen therapy, which can be taken orally in pill form, applied to the skin as a patch or cream, or inserted vaginally as a suppository.

Oral estrogen replacement therapy does have some downsides. Estrogen-only pills can increase the risk of endometrial cancer for females who still have their uterus. This is why the pills should be used as a short-term treatment or combined with a progestin to protect the lining of the uterus,

Younger females can also have vaginitis, typically caused by a bacterial or yeast infection. But postcoital bleeding is a far less common symptom among them.

Endometriosis affects between 5% and 10% of females of reproductive age.

Endometriosis

Endometriosis occurs when the lining of the uterus (the endometrium) grows outside of the uterus. When this happens, the endometrial tissue can attach itself to the surfaces of other organs, often resulting in excruciating pain and, in some cases, infertility.

Two of the characteristic symptoms of endometriosis are painful intercourse and painful orgasm. Postcoital bleeding is another symptom.

Hormone therapy to reduce estrogen levels is often effective for reducing pain.

Pain and bleeding may also be reduced by changing the positions you commonly use during sex. For example, the missionary position can place added stress on the vagina. It may be relieved by a side-to-side position.

Trauma

While postcoital bleeding is often associated with infections and abnormalities of the uterus, vagina, or cervix, bleeding can also result from an injury to these vulnerable tissues.

It may be caused by vigorous sex, which can lead to cuts, scrapes, or tears on the vagina. This is more likely to occur if there is vaginal dryness, which can occur during menopause, when a mother is breastfeeding, or from excessive douching.

Bleeding can occur as a result of sexual abuse or violence. Forced penetration can severely damage vaginal tissues and lead to the formation of fissures, wounds that can repeatedly heal and reopen unless they are medically treated.

Cancer

While cancer is a less likely cause of postcoital bleeding, this symptom is one of the possible signs of cervical, vaginal, and uterine cancer.

Tumors can vary depending on the type of cancer involved. And they tend to be fed by a dense, haphazard network of blood vessels.

As the tumor grows, these vessels can burst. Bleeding is a common feature of cervical cancer. It can occur during sex or without any specific trigger.

Cancer symptoms may include:

If you have these symptoms, your gynecologist will perform a pelvic exam, Pap smear, and possibly a visual exam called a colposcopy. A tissue sample may be taken by biopsy to be examined under a microscope.

Cervical Cancer Stats

Nearly 15,000 women are diagnosed with invasive cervical cancer in the United States every year, leading to more than 4,000 deaths.

Summary

Discovering blood during or after sex can be alarming, especially if you're not menstruating. The most likely causes include a sexually transmitted infection, benign polyps, cervical ectropion, atrophic vaginitis, endometriosis, trauma, and cancer.

A Word From Verywell

Never regard bleeding during or after sex as normal. It isn't. So if you don’t know what is causing you to bleed, see your physician as soon as possible. It may be difficult to set aside any cancer fears, but remember: Bleeding after sex isn't usually due to cancer, and most of the causes aren't serious.

Frequently Asked Questions

  • Does light spotting after sex mean I'm pregnant?

    Light spotting after sex could mean you are pregnant, but this is not always the case. There are many causes of light spotting after sex, some of which are not easily identified. It may be a good idea to visit a healthcare provider so they can help you discover the reason for bleeding.

  • Can a yeast infection cause bleeding?

    Yes, a yeast infection can cause bleeding. This usually occurs if the yeast infection progresses to cause vaginitis (vaginal inflammation). A yeast infection can also cause itching, redness, pain while urinating or during sex, and an odorless, white discharge.

  • How long does postcoital bleeding last?

    How long postcoital bleeding lasts may depend on whether it is due to vaginal or cervical bleeding. For example, direct trauma to the vaginal walls can cause heavy and bright-red bleeding that lasts for a short time. Cervicitis (inflammation) is also known to cause post-coital bleeding, but the duration of bleeding can vary.

  • Why does sex hurt?

    There are many possible reasons why sex may hurt. Most reasons will differ between sexes, but both men and women can experience pain due to an infection like thrush or an STI such as chlamydia and herpes. In women, pain during or after sex can be caused by vaginal dryness due to menopause, low sexual arousal, vaginismus, irritation caused by latex or spermicides, endometriosis, and more. In men, pain can be due to tight foreskin, prostate gland inflammation, small tears in foreskin, and more.

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8 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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