Sexual intercourse should be pleasurable and exciting, not painful or scary. If you notice blood coming from your vagina directly after sex, however, you’re probably scared, or at least worried.
There’s not a single cause for postcoital bleeding. That’s why you should contact your OB/GYN to find out what’s causing the bleeding and how to correct the issue or condition behind it.
At Elite Gynecology, our expert gynecologists, Molly McBride, MD, and Tamara Guichard, MD, want you to feel comfortable bringing us any issue that worries you, including postcoital bleeding. We conduct an in-depth physical exam, which may include imaging studies, to determine what’s behind your postcoital bleeding. Then we customize a treatment plan.
Are you frightened or worried because you bleed after sex? Following are some of the most common reasons for postcoital bleeding and how we may treat it.
Your hymen broke
If you only recently had penetrative sex, you could still have a thin tissue that covers the opening of your vagina called a hymen. Most girls and women break their hymens when they use tampons to soak up menstrual blood.
However, if you’ve never used a tampon and experienced intercourse or manual penetration for the first time, you could bleed. Once your hymen breaks, you shouldn’t bleed after sex again.
You’re having your period
You may see some spotting or light bleeding after sex if you’re about to start your period, or if you just finished it. Double check the dates to make sure that your bleeding isn’t related to your period. If it isn’t, read on.
You have an infection
Pelvic inflammatory disease (PID) and sexually transmitted infections (STIs) may cause you to bleed after sex. If you’ve had sex at least once before and you’re bleeding after penetration, be sure to come in for an examination and STI testing.
If you have a bacterial infection, we give you a course of antibiotics to eradicate it. You may need a fungicide or other treatment for a different types of STI. Be sure to use a condom whenever you have sex to minimize the risk of another infection.
Your vagina is torn or damaged
Having sex before you’re fully lubricated could cause small tears in your vagina that could bleed. You might also bleed after sex if you recently gave birth, which can traumatize and tear your vagina.
We may recommend lubricants to use during sex to keep your vagina moist and pliable. Or, if you have tears, we advise you to refrain from intercourse until they’ve healed.
You have atrophic vaginitis
If you’re in perimenopause or menopause (roughly early 40s to early 50s), the downshift in your hormones may cause your vaginal tissues to become thin and dry. Without sufficient lubrication, your vagina could be easily torn during sex.
While lubricants may help with atrophic vaginitis, we may prescribe hormone replacement therapy (HRT). When your hormones are balanced, your vagina and other tissues become stronger and rejuvenated so that you create more of your own natural lubricant.
You have benign growths
You may have polyps in the lining of your uterus or on your cervix that are irritated when you have sex, and they may bleed. If so, we remove these benign growths so you can have sex comfortably again.
You have cervicitis
Cervicitis is an inflammation of your uterine opening that could be caused by irritation or an infection. Even chemicals in a douche or the latex in condoms could cause cervicitis. We customize a treatment based on the cause of your cervicitis.
You have cervical erosion
Also known as cervical ectropion, cervical erosion refers to inflammation on your cervix, which is the opening to your uterus. This inflamed portion can also extend into your vagina, and could bleed during sex. We may prescribe boric acid suppositories to ease symptoms.
Only rarely is bleeding a sign of cancer
Although it’s rare, bleeding after sex could be a sign of a reproductive cancer. Cervical cancer, uterine cancer, and vaginal cancer could all cause bleeding after sex. If you have cancer, we refer you to an oncologist.
If you’re bleeding after sex, you need to find out why so we can give you the treatment and care you deserve. Contact us today at the office nearest you — in Midtown East, Murray Hill, New York City or Forest Hills, New York — or use our online appointment button.