Many women experience vaginal bleeding after s*x at one time or another. In fact, up to 63 percent of postmenopausal women experience vaginal dryness and vaginal bleeding or spotting during s*x. Additionally, up to nine percent of menstruating women experience postcoital bleeding.
Occasional light bleeding is usually not a cause for concern. If you have certain risk factors or have gone through menopause, bleeding after intercourse warrants a visit to the doctor.
Causes of bleeding after s*x
Bleeding after s*x is medically known as postcoital bleeding. It occurs in women of all ages. In younger women who haven’t reached menopause, the source of the bleeding is usually the cervix. In women who have gone through menopause, the source of the bleeding is more varied. It can be from the:
cervix
uterus
labia
urethra
In terms of causes, cervical cancer is the greatest concern. This is especially true for postmenopausal women. However, postcoital bleeding is more likely to be caused by a common condition.
Infections
Some infections can cause inflammation of the tissues in the v**ina, which may lead to bleeding. These include:
pelvic inflammatory disease
sexually transmitted disease (STD)
cervicitis
vaginitis
Genitourinary syndrome of menopause (GSM)
GSM was formerly known as vaginal atrophy. The condition is common in women in perimenopause and menopause, and those who’ve had their ovaries removed. As you get older, especially when your menstrual periods stop, your body produces less estrogen. Estrogen is the female hormone responsible for regulating your reproductive system.
When your estrogen levels are lower, several things happen to your v**ina. Your body produces less vaginal lubrication, so your v**ina can become dry and inflamed. Lower estrogen levels also reduce the elasticity of your v**ina. Vaginal tissues become thinner and shrink. This can lead to discomfort, pain, and bleeding during s*x.
Vaginal dryness
Vaginal dryness can lead to bleeding. In addition to GSM, vaginal dryness can be caused by many other factors, such as:
chest-feeding
childbirth
having your ovaries removed
certain medications, including cold medicine, asthma medications, some antidepressants, and anti-estrogen drugs
chemotherapy and radiation therapy
having intercourse before you are fully aroused
douching
chemicals in feminine hygiene products, laundry detergents, and pools
Sjögren’s syndrome, an inflammatory disease of the immune system that reduces moisture generated by glands in the body
Learn more: Postpartum vaginal dryness »
Polyps
Polyps are noncancerous growths. They’re sometimes found on the cervix or in the endometrial lining of the uterus. A polyp dangles like a round pendant on a chain. Polyp movement can irritate the surrounding tissue and cause bleeding from small blood vessels.
Vaginal tearing
s*x, especially vigorous s*x, can cause small cuts or scrapes to the v**ina. This is more likely to happen if you have vaginal dryness due to menopause, chest-feeding, or other factors.
Cancer
Irregular vaginal bleeding, including bleeding after s*x, is a common symptom of cervical or vaginal cancer. In fact, it was the symptom for which 11 percent of women diagnosed with cervical cancer first sought treatment. Postmenopausal bleeding can also be a symptom of uterine cancer.
Are you at greater risk of bleeding after s*x?
You may be at greater risk of postcoital bleeding if you:
have cervical or uterine cancer
are in perimenopause, menopause, or are postmenopausal
recently had a baby or are chest-feeding
have s*x with multiple partners without using condoms
aren’t fully aroused before intercourse
douche frequently
See a doctor for these symptoms
The symptoms you may experience along with postcoital bleeding vary depending on the cause. If you aren’t menopausal, have no other risk factors, and have only minor spotting or bleeding that goes away quickly, you probably don’t need to see a doctor. If you have any vaginal bleeding after menopause, see your doctor right away.
You should also consult your doctor if you have any of the following symptoms.
vaginal itching or burning
stinging or burning sensation when urinating
painful intercourse
heavy bleeding
severe abdominal pain
lower back pain
nausea or vomiting
unusual vaginal discharge
Cervical and uterine cancer
Vaginal bleeding, including bleeding after s*x, can be a symptom of cervical and uterine cancers. These cancers are most common in women over age 50 or women who’ve experienced menopause.
In addition to age, other risk factors include a family history of one of these cancers, being overweight (for endometrial cancer), or taking birth control pills for five or more years (for cervical cancer). Being infected with human papilloma virus (HPV) is another risk factor for cervical cancer.
If you experience postcoital bleeding and have gone through menopause, see your doctor to identify or rule out cervical and uterine cancers. As with other types of cancer, treatment is most effective when the cancer is found and treated early.
Complications
Serious complications from postcoital bleeding aren’t common, unless the cause is cancer or an untreated infection. Following are some possible complications.
Anemia
Heavy or prolonged bleeding can cause iron-deficiency anemia because the red blood cells in your body are depleted through blood loss. Signs of anemia include:
fatigue
weakness
dizziness
headaches
unusually pale skin
If your anemia is caused by blood loss, your doctor may prescribe an iron supplement. But the most important source of iron is diet. If you are concerned about your iron levels, add more of these iron-rich foods to your diet:
iron-rich foodsInfection
If you have vaginal dryness, you are at greater risk of getting a urinary tract infection.
DIAGNOSIS
Identifying the cause
Bleeding after s*x is a symptom of many conditions. Your doctor will first rule out cancer by examining your v**ina and cervix, taking a pap smear, and possibly conducting a biopsy. If cancer is found, you’ll be referred to a specialist.
After cancer is eliminated as the cause of your bleeding, several steps may be taken to determine the source:
examination of your v**ina and cervix, either visually or through a magnifying device called a colposcope
transvaginal ultrasound
urine test
blood tests
testing of your vaginal discharge
Treating postcoital bleeding
The cause of your vaginal bleeding will determine your treatment.
Lubricants
If your bleeding is caused by vaginal dryness, vaginal moisturizers can help. Applied regularly, these products are absorbed by the walls of the v**ina. They increase moisture and help restore the natural acidity of the v**ina.
Vaginal lubricants also reduce uncomfortable friction during intercourse. You may want to avoid products containing parabens or propylene glycol.
Caution
Petroleum-based lubricants, such as Vaseline, can damage latex condoms and diaphragms. Don’t mix Vaseline and condoms. Use a lubricant containing water or silicone if this is a concern.
Estrogen therapy
If your vaginal dryness is caused by menopause or removal of the ovaries, talk with your doctor about estrogen therapy. Topical estrogen products include vaginal estrogen creams and suppositories. Another option is an estrogen ring. This is a flexible ring that’s inserted in the v**ina. It releases a low dose of estrogen for 90 days.
Oral hormone therapy, which replaces the hormones estrogen and progestin, is another option for some women. Talk with your doctor about the risks and benefits of this treatment.
Additional treatments
Vaginitis can be caused by infection or vaginal dryness. The cause may also be unknown. Depending on the cause, your doctor may prescribe an antibiotic.
Antibiotics may also be prescribed to treat pelvic inflammatory disease and STDs.
If your cervix has been damaged by an infection, your doctor may remove affected cells using silver nitrate or cryosurgery. In this process, damaged sells are frozen and killed.
Outlook
Bleeding after s*x is usually a symptom of another condition. Many of these, such as infections and polyps, are treatable. Occasional spotting after s*x generally clears up on its own without medical care. If you’re postmenopausal, promptly notify your doctor about any postcoital bleeding
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