What is bleeding after sex?

Bleeding after sex is a condition in which there is any type of light to severe bleeding from the vagina after vaginal sexual intercourse. Bleeding after sex, also known as bleeding after intercourse or post-coital bleeding, can result from a variety of conditions or diseases that include:

Abnormal growths (such as polyps or fibroids) on the cervix or in the uterus

Abnormal cells of the cervix (possibly precancerous cells)

Infection or inflammation of the vagina, uterus or cervix

Malignancy (cancer)

Trauma to the vagina or cervix

Bleeding after sex is not normal. However, many underlying causes of bleeding after sex, such as vaginal dryness and cervical dysplasia, are very treatable if promptly diagnosed and treated. Treatment of bleeding after sex varies and is tailored to the individual case, the underlying cause, the severity of symptoms, and the presence of any complications.

Sometimes bloody urine, which is due to bleeding from the urinary tract, or bloody stools, which is due to bleeding from the gastrointestinal tract, can be mistaken for vaginal bleeding after sex. Any unexplained bleeding should be evaluated by your healthcare professional.

Some types of bleeding after sex can be caused by serious, even life-threatening, conditions, such as cervical cancer or sexually transmitted diseases (STDs). Seek prompt medical care if you experience bleeding after sex, even if it is light spotting. Early diagnosis and treatment of bleeding after sex reduces the risk of serious complications, such as infertility and metastatic uterine cancer.

What other symptoms might occur with bleeding after sex?

Bleeding after sex may occur with other symptoms depending on the underlying disease, disorder or condition. For example, bleeding after sex due to vaginal dryness and tearing may occur with other symptoms of menopause, such as mood swings and cessation of menstrual periods.

Symptoms that may occur along with bleeding after sex

Bleeding after sex may occur with other symptoms including:

Difficulty getting pregnant or infertility

Fever

Lower back pain

Nausea and vomiting

Painful bowel movements

Painful sexual intercourse

Pelvic or abdominal pain or cramps

Symptoms of menopause (cessation of menstrual periods, loss of sexual desire, vaginal dryness)

Unusual vaginal discharge

Symptoms that might indicate a serious or life-threatening condition

In some cases, bleeding after sex can be a sign of a serious or life-threatening condition, such as cervical cancer, a sexually transmitted disease (STD), or uterine cancer. Seek immediate medical care (call 911) if you have any of the following symptoms:

Dizziness

High fever (higher than 101 degrees Fahrenheit)

Severe pelvic or abdominal pain

Severe or heavy vaginal bleeding

Vaginal bleeding during pregnancy

What causes bleeding after sex?

Bleeding after sex, even if it consists of light spotting, is not normal. Bleeding after sex may be caused by a relatively minor condition, such as vaginal dryness, but it may also be caused by serious or life-threatening conditions, such as cervical cancer or pelvic inflammatory disease.

Potential causes of bleeding after sex

Bleeding after sex can be caused by a variety of diseases, disorders or conditions that affect the vagina, cervix or uterus. Underlying causes of abnormal bleeding after sex include:

Atrophic vaginitis, thinning and inflammation of the lining of the vagina from decreased estrogen production

Cervical dysplasia, abnormalities in cells of the cervix that can lead to cervical cancer

Growths on the cervix or in the uterus, such as cervical polyps, uterine polyps, or uterine fibroids

Malignancies, such as cervical cancer, vaginal cancer, or endometrial cancer (uterine cancer)

Pelvic inflammatory disease (PID), an infection of the uterus, fallopian tubes, or other reproductive organs

Sexually transmitted diseases (STDs), such as chlamydia, gonorrhea and trichomoniasis

Vaginitis or cervicitis, an infection or inflammation of the vagina or cervix, which may be caused by STDs or other types of infections, such as a vaginal yeast infection or Gardnerella vaginalis infection

Trauma to the vagina or cervix due to vaginal dryness and lack of lubrication, or traumatic sexual intercourse due to child abuse or sexual assault

How is bleeding after sex treated?

Diagnosing the reason for bleeding after sex is the first step to treatment. Your doctor will perform a pelvic exam and visually examine your genitalia, vaginal canal, and cervix for abnormalities. Your doctor will perform a Pap test (also called a Pap smear) and may also want to test you for infection. Your test results will determine next steps.

Treatments for specific causes of bleeding after sex include:

Atrophic vaginitis and vaginal dryness: A first-line treatment is lubrication during sex. You can purchase lubricating products over the counter. If you are postmenopausal, your doctor may suggest estrogen replacement, which comes in many forms, including a cream you apply to the inside of the vagina and labia.

Cancerous or precancerous cells of the cervix: A Pap smear can identify abnormal cells and early signs of cervical cancer. In-office procedures, such as LEEP (loop electrosurgical excision), effectively remove abnormal and precancerous cells. Your doctor will refer you to a gynecologic oncologist to confirm a diagnosis and treat cervical cancer as well as vaginal or uterine cancer.

Cervical polyps: Your doctor may recommend removing these growths if your bleeding after sex is severe.

Infection and inflammation: Antibiotics can clear up bacterial infections; topical steroids applied around and inside the vagina can reduce swelling and pain.

What are the potential complications of bleeding after sex?

In some cases, bleeding after sex can be due to an underlying condition that can result in serious or life-threatening complications. You can minimize the risk of serious complications of bleeding after sex by seeking early medical care and following the treatment plan designed by you and your healthcare professional. Complications of bleeding after sex and its underlying cause can include: