9 reasons you could be bleeding during or after sex

Unexpected spotting? We to speak to the experts.

bleeding during after sex
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If you are in the throes of passion and suddenly you spy spots of blood on the bed sheets, it can be alarming (and a bit embarrassing if you're in a new relationship). Have you cut yourself? Did you miscalculate your period date? No, so why are you bleeding?

Bleeding during or after sex an be unexpected and unnerving in equal measures – but there are a number of reasons this could be happening and it's unlikely to be anything serious, so try not to worry. The most important thing is to always get checked out by your doctor if something is amiss.

We ask the experts about common reasons for bleeding during sex and what to do if you're worried:

Why are you bleeding during sex?

According to research, nine per cent of women experience unexpected spotting or bleeding either during or after sex, and as many as 63 percent of postmenopausal women, so if you do notice a few worrying spots of blood on the bed sheets, you are not alone.

But it's important to say that if you do experience vaginal bleeding, you shouldn't just ignore it. 'Unexpected bleeding from any part of the body should never be ignored, and vaginal bleeding is no different,' says Dr Helen Webberley from Webdoctor.

'Whether it is a smear on the toilet paper or knickers (spotting), or an unexpected flow that needs some kind of sanitary protection (bleeding) - it is important to ask yourself some questions.'

Dr Jane Ashby agrees. 'There are a number of reasons why a woman may bleed after sex, including hormonal reasons such as certain contraptions, vulval skin problems, early pregnancy and many more. The important thing is to get checked up early.'

Here, we speak to the experts to find the most common reasons you could be bleeding during sex - or between periods:

1. Contraception and bleeding

A new pill, missed pills, or a change in contraception could lead to unexpected bleeding, but don't just assume this is the case and move on. It's still a good idea to get it checked out.

'Before you just blame your contraceptive pill or similar, think whether you are up to date with smear tests or whether there is any chance (expected or possible) of infection...' says Dr Webberley.

'If it happens just after a change in contraceptive method then that can be expected, but if it persists or comes out of the blue, then make sure you get it checked.'

Head to your GP for a check-up, so they can run some tests to rule out anything more serious.

2. STIs and bleeding

Bleeding during sex could also be as a result of a sexually transmitted infection (STI). 'Unexpected bleeding either after sex or in between your period can be a sign of a sexually transmitted infection,' says Dr Ashby. 'It's a good idea to get it checked out promptly to exclude infections such as Chlamydia or Gonorrhoea.'

A lot of STIs are treatable with antibiotics so the sooner you detect and treat them the better.

And don't put it off. 'A lot of sexually transmitted infections are curable or treatable with antibiotics and so the sooner you detect and treat them - the better,' she adds.

Arrange a check-up with your local sexual health clinic, or through your GP, if you think this could be the cause.

3. Sensitive skin and bleeding

Sensitive patches or polyps could also be to blame for bleeding during or after sex, as these can be agitated by having sex which may cause spotting.

'Your nurse or doctor at your GP surgery or local sexual health clinic can have a quick look inside and see if there is an obvious raw patch,' says Dr Webberley.

'Sometimes a small polyp (fleshy dangly bit) on the neck of the womb (cervix) at the top of the vagina can bleed after sex. Sometimes the skin on the cervix can become very thin (ectropion) and bleed on contact.'

The best advice is to head straight to your GP to have an examination. 'I would always offer an examination and if she would like, perform some simple painless tests for infections,' says Dr Ashby. 'If she had not had an up-to-date cervical smear test I would take the opportunity to perform this.'

4. Pregnancy and bleeding

Early pregnancy can also be a cause of unexplained bleeding. So, if you notice spotting during sex or between periods, take a pregnancy test as soon as you can.

If you notice spotting during sex or between periods, take a pregnancy test as soon as you can.

'A pregnancy test is really important with unexplained bleeding to exclude early pregnancy and identify the possibility of an ectopic pregnancy which requires urgent medical treatment,' says Dr Ashby.

You could take a pregnancy test at home, but it's best to get this done at the doctor's so they can take action straightaway if needed - and rule out any other causes of bleeding if you're not pregnant.

5. Menopause and bleeding

Age could also be a factor in vaginal bleeding or bleeding during sex. 'As we age, especially post-menopausal, women experience vaginal atrophy - our delicate vaginal skin loses oestrogen, becomes drier and thinner, this may result in bleeding,' explains Tracie Miles, a gynaecology nurse at The Eve Appeal.

So, if you're expecting to hit the menopause soon, or are already there, this could well be the cause of the bleeding. But, again, it's best to get a quick check-up by your doctor to rule out any more serious causes.

6. Cervical cancer and bleeding

There are, of course, some other potentially serious reasons for vaginal bleeding. 'One cause of bleeding after sex can be because of changes or abnormalities in the neck of the womb, the cervix,' says Dr Ashby.

'These changes may be inflammation due to infection or sometimes due to cell changes or growths including, occasionally, cancer,' she adds.

One cause of bleeding after sex can be because of changes or abnormalities in the neck of the womb, the cervix.

'It's important to do an examination to check the appearance of the cervix, and stay up-to-date with smear tests. Because bleeding after sex can sometimes be due to these changes, consulting with a doctor is highly recommended.'

If you're worried that the bleeding may be connected to cervical abnormalities or you're not up-to-date to with your smear tests, book one in now. If your smear tests are up-to-date, book an appointment with your GP anyway to discuss your concerns and they can help you find the cause.

7. Endometriosis and bleeding

Endometriosis could be responsible for vaginal bleeding. Endometriosis is a condition in which the tissue (endometrium) normally lining the womb (or uterus) is found on organs outside the uterus.

'Some women with endometriosis may report irregular bleeding or spotting, but this is not usually the predominant feature of endometriosis and it's important to exclude other more common causes of irregular bleeding before attributing unexpected bleeding to endometriosis,' says Dr Ashby.

Book in a GP appointment and ask them to run some tests to find what's causing the bleeding.

8. Cervical ectropion

This can occur in young women in their teens as well as pregnant women and those taking the contraceptive pill. It is a harmless and common problem, that causes the cells which normally lie just inside the neck of the womb to protrude slightly outside it through the opening of the cervix. These have a fragile blood supply and so can bleed easily on very mild trauma such as sex, putting a tampon into the vagina or having an internal medical examination.

9. Trauma

Vigorous foreplay and deep sex can cause cuts, abrasions or tears to the lining of the vagina including by a fingernail during love play – this is not unusual. This tissue is sensitive and easily damaged and so if vaginal dryness is present then trauma is more likely to occur. This is more likely during breastfeeding or during and after the menopause, as well as in women who douche their vagina excessively.

These often require no treatment and settle with time but if they cause significant bleeding they can be simply cured by cauterizing the area, using diathermy (heat), cryosurgery (cold) or silver nitrate.

Vaginal bleeding treatment

While there are potentially serious causes of vaginal bleeding, there are also many much less serious concerns that can cause bleeding during sex or between periods.

'The treatment of each women would depend on the findings. Many times, it's about excluding the serious and the treatable causes and providing some reassurance,' says Dr Ashby.

When should you visit the doctor?

It's important to remember that if you have any concerns at all about your vaginal health, your doctor should be your first port of call.

If you do experience any bleeding during, or after, sex - or between periods - don't just brush it off. 'The most important message is that unexpected bleeding from anywhere should not be ignored,' says Dr Webberley.

Dr Ashby agrees: 'There are a whole host of other reasons why women may bleed after sex, and it's important to see a doctor who can offer you an examination and some tests to look into why the bleeding is occurring.'

For more information, visit our women's health collection.

Last updated: 21-07-20

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