Let’s start with some good news, blood after sex isn’t always a reason to worry. The majority of the time, postcoital bleeding is the result of something simple and it may go away on its own [1]. Having said that, if you’ve been bleeding after sex, it’s important to know more.

We're going to take a closer look at the causes of blood after sex and if it’s something that you should be concerned about.



What are the causes of blood after sex?


When you notice postcoital bleeding, there’s usually a simple explanation - such as a small tear in the vaginal walls due to friction during intercourse or the use of a foreign object for penetration [2].

If you have an inkling that neither of the above is the case, here are some of the most common causes of blood after sex:

Infection

There are a handful of infections that can cause the tissues of the vagina to become inflamed which can sometimes result in abnormal bleeding [3].

These infections can include:

  • Pelvic inflammatory disease
  • STIs
  • Cervicitis
  • Vaginitis

Vaginal dryness

Vaginal dryness is a common issue that many women experience and can sometimes cause postcoital bleeding [4],[5].

Vaginal dryness is common amongst those who are:

  • Taking the contraceptive pill
  • Experiencing menopause
  • Breastfeeding
  • Undergoing cancer treatment

Cervical or endometrial polyps

Cervical or endometrial polyps are small non-cancerous growths found on the inside of the uterus or womb [6]. You can have one or many polyps and women of any age can contract them.

Common symptoms include:

  • Irregular menstrual bleeding
  • Bleeding between menstrual periods
  • Excessively heavy menstrual periods
  • Vaginal bleeding after menopause
  • Infertility

Cervical ectopy

It’s common for women who take oral contraceptives to experience cervical ectopy - a red and often raw looking area located on the surface of the cervix. This is usually a result of having high levels of estrogen in the body [7].

Common symptoms include:

  • Unexpected vaginal bleeding during or after sex
  • Blood streaked discharge during or after sex
  • Spotting during or after sex

Should I get tested?


If you’re experiencing regular postcoital bleeding, it’s important to see your doctor to get a better understanding of what the underlying cause is.

Is bleeding after sex a sign of an STI?

There are a number of reasons you may be bleeding after sex and STIs are a common cause, though they’re not the only cause.

If you’re worried that you may be experiencing postcoital bleeding as a result of contracting an STI, don’t be. Once they’re detected early and identified, the majority of STIs can be treated. Put your mind at ease by taking a test - you can do this by visiting your local doctor or taking a test from home.



You should consider taking an STI test if:

  • You’ve become sexually active
  • You have had unprotected sex
  • You are experiencing symptoms of a sexually transmitted infection
  • You are entering into a new sexual relationship
  • You have received a notification from a previous partner that they are infected

References

  1. Cleveland Clinic. Do you bleed after sex? When to see a doctor. Online: Health.clevelandclinic.org, 2017
  2. Mayo Clinic Staff. Vaginal bleeding after sex. Online: Mayoclinic.org, 2018
  3. NHS. What causes a woman to bleed after sex? Online: Nhs.uk, 2018
  4. NHS. Vaginal dryness. Online: Nhs.uk, 2018
  5. NHS. What causes a woman to bleed after sex? Online: Nhs.uk, 2018
  6. NHS. What causes a woman to bleed after sex? Online: Nhs.uk, 2018
  7. NHS. Cervical Ectopy. Online: Mft.nhs.uk, 2018