Bleeding After Sex

Medically Reviewed by Jabeen Begum, MD on May 16, 2024
Written by Anne Machalinski, Allison Torres Burtka
9 min read

If you notice you're bleeding after having sex with your partner, and you don't have your period (or it's not supposed to come anytime soon), you may be experiencing vaginal bleeding. 

Is it normal to bleed after sex?

Vaginal bleeding after sex, also known as postcoital bleeding, can be scary, but it's also fairly common. It affects up to 9% of people who get a period. There's probably no cause for concern. But it can also result from an infection. In rare cases, it's a sign of cervical cancer.

Even though bleeding after sex is fairly common, that doesn't mean it's normal. If it happens once and the blood is only light spotting, it's probably not serious. But if the bleeding is heavy, it lasts for a few days, or it happens often, it could be a sign of something serious.

The most common causes of vaginal bleeding after sex both start in the cervix, which is the narrow, tubelike end of your uterus that opens into the vagina.

One of those causes is irritation or infection of the cervix, called cervicitis. It can happen because of a sexually transmitted infection that you need to get treated, like chlamydia or gonorrhea. Or it can happen from an infection that is not sexually transmitted, like a yeast infection. These infections lead to inflammation, which can cause bleeding after sex.

A second common reason for bleeding after sex is cervical polyps. These growths are usually small--about 1 to 2 centimeters. They often appear on the opening of your cervix. Most aren't cancerous. Your doctor can remove them during an appointment.

Other causes of vaginal bleeding after sex include:

  • Friction during sex or not enough lubrication
  • Normal uterine bleeding if you're just beginning your period or if it has just ended
  • Genital sores caused by herpes or another condition
  • Cervical ectropion, a condition when the inner lining of your cervix pokes through the cervical opening and grows on the other side of the cervix, closer to your vaginal opening
  • Uterine prolapse, which can happen when the tissues around your uterus become weak, and your uterus sags or drops into your vagina
  • Cancer of the cervix, vagina, or uterus
  • Precancerous cells in the cervix, vagina, or uterus (abnormal cells that may develop into cancer)
  • Pelvic inflammatory disease (PID), which is an infection of the uterus, fallopian tubes, or ovaries
  • Hormonal birth control
  • An intrauterine device (IUD) that has been placed incorrectly
  • Damage or trauma to the vagina from childbirth or injury

Dryness can also lead to vaginal bleeding. Dryness can be caused by:

While many of these causes are harmless and don't need treatment, sometimes vaginal bleeding after sex can signal a serious problem that you should see a doctor about right away.

Heavy bleeding after sex

If you're having heavy bleeding after sex, you should see your doctor. Possible causes vary, but heavy bleeding may be serious.

If you have sudden, unusual episodes of abnormal bleeding, this is called acute abnormal uterine bleeding. If this happens and you have chest pain or shortness of breath, or you feel lightheaded or dizzy, you need emergency care.

If you're pregnant and have heavy bleeding after sex, it's important to get medical care right away, because bleeding may be a sign of miscarriage or ectopic pregnancy, when the fertilized egg implants outside of your uterus. Ectopic pregnancy can be life-threatening.

Pain and bleeding after sex

Uterine prolapse can cause both bleeding and pain. You may feel pain in your pelvis, abdomen, or lower back, and it may be painful during sex. Cervical ectropion can also cause both pain and bleeding.

Endometriosis is a condition where tissue that's similar to the lining of your uterus grows outside of the uterus. It can cause pain after sex, and it’s usually linked with heavy periods, but it can also cause bleeding between periods. 

Implantation bleeding after sex

Implantation bleeding can happen when a fertilized egg implants into the lining of your uterus, which usually happens about 6 to 12 days after the egg is fertilized. This may be before you realize you're pregnant. 

This implantation can cause light bleeding. Not everyone experiences implantation bleeding, but it's a normal part of pregnancy. If you have light bleeding after sex, it could be implantation bleeding. 

You may have a higher chance of bleeding after sex if you:

  • Have an infection of the cervix, which can be from a sexually transmitted disease or another infection, like a yeast infection
  • Have cancer of the cervix, vagina, or uterus
  • Use douche products 

Because vaginal dryness can cause bleeding after sex, you may be more likely to bleed if you:

  • Are going through menopause or perimenopause (the transition to menopause)
  • Had a baby not long ago or are breastfeeding
  • Aren't fully aroused before vaginal penetration

If you have some minor bleeding every once in a while, chances are everything is fine. But the only way to know for sure is to see your doctor for a physical exam.

If the bleeding happens right before you get your period or within a few days after it ends and it doesn't happen again, you can hold off on making that appointment. You can also probably hold off if you recently had a pelvic exam and Pap smear and got a clean bill of health. In all other cases--or if you’re just worried--it's best to get checked out to rule out infection or anything more serious.

If you're postmenopausal, meaning you have gone through menopause, any bleeding after sex isn't normal. See your doctor to rule out cervical cancer, endometrial cancer, and other issues.

During menopause and perimenopause (the transition before menopause), your body's levels of the hormone estrogen decrease. When that happens, the lining of your vagina can get drier and thinner, leading to a condition called genitourinary syndrome of menopause (GSM). This condition used to be called vaginal atrophy. This drier and thinner lining can cause bleeding from the friction of sex. 

Vaginal bleeding after sex can be scary if you're pregnant, but it probably isn't a cause for concern. Your cervix may bleed more easily during pregnancy because extra blood vessels are developing in the area. That can cause bleeding, especially after sex. 

Still, if you're pregnant and you have bleeding after sex, it's a good idea to check with your doctor, because it could be a sign of a problem with the pregnancy.

Bleeding after sex postpartum

In the postpartum period, after childbirth, you may have vaginal dryness, especially if you're breastfeeding. That may cause bleeding after sex. 

If you had a vaginal tear during childbirth, it may still be healing during the postpartum period. To avoid pain and bleeding during sex, you may want to have your doctor check to see if the tear has healed.

Your doctor's first step will probably be to ask you some questions to see if there's an obvious cause for the bleeding, like breakthrough bleeding after you just start to take a birth control pill. They may ask whether you've been having heavy or irregular periods.

They'll also want to know if you're having pain during sex, which can be a sign of dryness or an infection, such as a sexually transmitted disease like chlamydia.

Your doctor may give you a pelvic exam and look for any source of the bleeding, like vaginal tears or lesions, signs of uterine prolapse, cervical polyps, or inflammation. If you have polyps, they might be able to remove them in the office and send them to a lab for testing. Or you might need a later appointment to have them surgically removed.

Your doctor may also give you a:

  • Pregnancy test
  • Test for a sexually transmitted disease or sexually transmitted infection
  • Transvaginal ultrasound
  • Pap test
  • Colposcopy, using a microscope called a colposcope to check your cervix

If you're postmenopausal, your doctor might do a transvaginal ultrasound to get a closer look at your pelvic organs. They might also do an endometrial biopsy to check for abnormal cells in the endometrial tissue that lines your uterus.

During a Pap test, your doctor uses a tool called a speculum to examine your vagina and cervix, as well as swab your cervix to test for any sign of abnormal, precancerous growths or cancer cells. They also use the test to check for any sexually transmitted infections like chlamydia and gonorrhea, which can cause bleeding after sex. Those infections can be treated with antibiotics.

If bleeding after sex is an ongoing thing, your doctor may recommend a colposcopy even if your Pap test results are normal, to get a better look at your cervix.

Abnormal pap test

If the results of your Pap test are abnormal, that means some of the cells taken from your cervix didn't look completely normal. But it doesn't mean you have cancer. Depending on what type of abnormal cells were found, your doctor may recommend further testing, monitoring, or treatment.

If the pap test reveals problems with your cervix, the next step may be getting a colposcopy. It starts out like a Pap test but takes a bit longer. The doctor will use a special magnifying device called a colposcope to get a closer look at the cervix. If they see anything suspicious, they can take a small sample of tissue for testing.

Since there's not just one cause of bleeding after sex, there's no single treatment. Some options include:

  • Vaginal lubricants and moisturizers. If your bleeding is caused by dryness, better lubrication during sex may eliminate the bleeding. 
  • Estrogen therapy. If decreased estrogen and GSM have caused vaginal dryness, estrogen therapy can help. 
  • Medication. If you have an infection, including a sexually transmitted infection, your doctor will prescribe antibiotics or other treatment.
  • Cancer treatment. If the underlying cause of your bleeding is cancer, the treatment you get (surgery, chemotherapy, or radiation) may stop the bleeding.
  • Polyp removal. If your doctor found polyps that are causing your bleeding, removing them can stop it. 

 

It might. Depending on the underlying cause of your bleeding, it may go away on its own. If it happens once, it may not be a problem. 

But if your bleeding after sex keeps happening, you should see a doctor. Even if the bleeding doesn't happen very often, it may be a good idea to talk to a doctor, so they can make sure that the cause of your bleeding after sex is not a serious problem, and that you can get treatment if you need it. 

You can make some lifestyle changes to lower your risk of bleeding after sex:

  • Use a lubricant before and during sex
  • Wait a bit longer after your period ends to start having sex again
  • Have your doctor remove any cervical polyps or treat cervical infections
  • Have more foreplay before penetration
  • Try less aggressive sex

 

Sometimes abnormal uterine bleeding can cause iron deficiency or iron deficiency anemia, because the red blood cells and hemoglobin that you lose through bleeding don't get replaced quickly enough. If you're having heavy bleeding, it's important to see a doctor to treat the problem. 

Bleeding after sex can have many different causes. Some of them are not serious and the bleeding will go away on its own, but other causes, such as cancer, are serious and require medical treatment. If you're bleeding after sex, it's a good idea to check with your doctor, so they can find out what the cause is and what you can do about it moving forward.

  • Is it normal to bleed a little after sex? Bleeding after sex is fairly common, but it's not normal for it to keep happening. If you often bleed after sex, check with your doctor about it.
  • What STD causes vaginal bleeding? Several sexually transmitted diseases can cause vaginal bleeding, including herpes, gonorrhea, and chlamydia.
  • Is bleeding normal after losing virginity? Yes. If your hymen breaks during sex, you might have bleeding afterward.
  • Is it normal to bleed during sex after a period? Yes. Sometimes bleeding after sex can happen within a few days of your period, either before it starts or after it ends.