All good things. However: On the rare occasion, sex can have other, not-so-desirable effects on our bodies—and unexpected bleeding is one possibility.
Ever snuck out to pee after sex (which is a very good call, BTW) and noticed a few drops of blood on your TP? Or found an unexpected streak of blood on your sheets after waking up the next morning? Depending on the timing, it could be your period—but bleeding during or after sex can happen for a number of other reasons, too.
If you’ve triple-checked your period tracker app and ruled out menstruation as a possibility, those drops of blood could be something as innocent as a little bit of tearing thanks to rougher-than-usual sex (we’re all for it, but don’t hold back on the lube!). However, they could also be an early indication of a more serious condition—and this is why it’s so important to report any instances of postcoital bleeding to your healthcare provider.
Here’s what you need to know about bleeding during or after sex, including when to talk to a doctor, what sort of bleeding is “normal,” and what other symptoms to look out for.
Why am I bleeding after sex? Common causes
We’ve said it before and we’ll say it again: Pay attention to your vagina! It can tell you more about your underlying health than you might think.
Anything that’s noticeably outside the norm for you—and, remember, this might not be the same as the “norm” for your best friend—is worth bringing up to your PCP or healthcare provider. This includes bleeding when you wouldn’t typically expect it.
If you’re not on your period, vaginal bleeding can be caused by a range of issues affecting the reproductive system. Some of the conditions that could cause you to bleed during or after sex include: 1 2
- Vaginal atrophy or vaginal dryness
- Trauma to the vagina or cervix
- Friction (due to a lack of lubrication or foreplay)
- Vaginal infections, including certain STIs (chlamydia trachomatis, gonorrhea, pelvic inflammatory disease)
- Genital sores (such as those brought on by genital herpes or syphilis)
- Cervical ectropion
- Cervical or endometrial (uterine) polyps
- Uterine prolapse
- Cervical or endometrial (uterine) cancer
While many of the above conditions are treatable or relatively benign, it’s important to note that postcoital bleeding is one of the first symptoms of cervical cancer. About 11% of people with cervical cancer experience some bleeding during or after sex. 3
Don’t panic, though: The prevalence of cervical cancer has gone down in recent years, largely thanks to the uptick in screening. Just make sure you’re getting regular Pap smears and pelvic exams.
Bleeding during or after sex isn’t uncommon if you’re having rough sex or if you tend to experience vaginal dryness (or a combination of those two factors). Also, keep in mind that bleeding or light spotting is pretty common after your first time having penetrative sex—or even your first couple of times. This happens as a result of the tearing or stretching of the hymen.
What if it really is your period?
It’s not unheard of to start your period a bit sooner than you expected after having sex—but when we say “a bit sooner,” we mean by a couple of days, and not a whole week or more. If your period was already scheduled to arrive, having sex that ends in an orgasm (the orgasm being the key factor at play here) could theoretically kick-start the uterine contractions that speed up the shedding of your uterine lining.
Nothing is more of a buzz-kill than unexpectedly staining the sheets when your period arrives mid-sesh. But don’t let a little blood stop you from having fun: Try a menstrual disc, like Flex Disc, next time you’re on your period and have all the mess-free period sex your heart desires. Want to learn more about having sex with a menstrual disc? Read all about it here.
When to see a doctor about bleeding during sex
As with most things that have to do with your reproductive health, you’re better safe than sorry. Unless you are absolutely certain that the bleeding you noticed after your most recent romp between the sheets was really your period, you should mention it to a healthcare provider—ASAP.
If possible, take note of the amount of blood, what day of your cycle you were on, and where the blood seemed to be coming from. Try to relay as much detail as possible, for example, if you’re bleeding after sex with no pain or if it is painful during or after intercourse. Your provider will likely perform a pelvic exam and may recommend additional testing (for example, a Pap smear, sexually transmitted infection or STI screen, or biopsy) to check for underlying conditions. 3
Other symptoms to look out for include:
- Unusual vaginal discharge
- Unusual or foul vaginal odor
- Pain during sex
- Pelvic pain
- Painful urination
- Flu-like symptoms or fever
- Abnormal, unusually heavy, painful, or irregular periods
If any of the above apply to you, make sure to mention them to your healthcare provider in addition to describing the nature of the postcoital bleeding you’ve been experiencing. The sooner you get a diagnosis, the better—even if that diagnosis ends up being something totally harmless, like vaginal dryness.
The only time you’re off the hook for that chat with your doctor? If you’re 100% sure the bleeding was due to your period or if it was your very first time having penetrative sex, you can skip it (for now). In those cases, do keep an eye out for unexplained bleeding the next time you have sex, and if it happens, you know what to do.
Bleeding during sex vs. postcoital bleeding: Does the timing matter?
Healthcare professionals typically put non-menstrual bleeding that happens either during sex or after sex into the same category. 2 The exact timing isn’t important. You might be a little bit too distracted to notice exactly when those first drops of blood were shed, anyways—so don’t stress if you can’t pin down those details.
We will note, however, that vaginal bleeding after sex can sometimes be confused with bleeding coming from other areas, such as the urinary tract (which could signal a UTI or other bladder infection) or the rectum. A small mirror and a clean tissue can come in handy when identifying exactly where the blood is coming from—but if you can’t tell, no worries. Just keep your provider in the loop and take note of any other symptoms (like burning when you pee or unusual odor).
How to prevent bleeding during or after sex
If you’ve talked to your doctor and you’ve determined that your post- or mid-sex bleeding is not due to an underlying condition, but simply due to friction and/or vaginal dryness, there are a few steps you can take to prevent it.
Firstly: Don’t skip the foreplay! Take your time warming up your body and exploring your partner’s, while you’re at it. Kissing, touching, or even introducing a toy for a few minutes longer than usual will give your body time to produce the natural lubrication that makes sex all the more enjoyable.
If your body has a tougher time getting into WAP mode—which can happen as a side effect of certain medications, as the result of a hormonal imbalance, or when approaching or in the midst of menopause—break out some body-safe lube.
While K-Y Jelly is always a solid bet, nowadays, there are tons of options on the market: A few newer brands are even making lubes with CBD—a natural compound that’s been anecdotally shown to increase feel-good sensation while reducing pelvic pain for those who experience dyspareunia (but keep in mind that none of these claims are proven).
Low estrogen to blame? Your provider may be able to prescribe a cream or pill to help boost your hormone levels and help your body produce more of its own lubrication. 3
Postcoital bleeding in unique circumstances: With an IUD, during pregnancy, or after menopause
BLEEDING AFTER SEX WHEN YOU HAVE AN IUD
Sometimes after insertion, hormonal IUDs can cause breakthrough bleeding. This is especially common during the first 2-6 months following placement.
If you have a hormonal IUD (like Mirena, Kyleena, or Skyla), you may notice some light bleeding or spotting during or after sex, especially if you’re nearing the time when you’d typically get your period. This is generally not something to be super worried about, but keep an eye on the bleeding and reach out to your provider if it doesn’t stop after a few hours.4
Sidenote: If you have the copper IUD and notice bleeding after sex, you should call your healthcare provider immediately. They will probably want to verify that the device hasn’t been dislodged or bumped out of place. While uncommon, IUD displacement can lead to bleeding and may require urgent attention. 5
BLEEDING AFTER SEX DURING PREGNANCY
While bleeding at any time while pregnant might be super scary, it’s actually fairly common: Vaginal bleeding occurs in 15 to 25 percent of pregnancies. Generally, it occurs during the first trimester, but it can happen at other times for a number of reasons—some of which are harmless, and others which could be a cause for concern. 6
If you notice light to medium bleeding during or after sex while pregnant, it could simply be due to the fact that the cervix becomes more tender and vascular during pregnancy. These cervical changes are normal and nothing to worry about.
The American Pregnancy Association recommends that pregnant individuals talk to their doctor before having penetrative sex again if they notice any bleeding. This is mainly to prevent further irritation. 7
Vaginal bleeding after sex while pregnant could, in rarer cases, be a sign of miscarriage or ectopic pregnancy. In the event of a miscarriage, however, you would likely experience heavy bleeding for a prolonged period. Light spotting is generally nothing to worry about. (P.S. Don’t believe any myths you’ve heard about sex leading to miscarriage: having normal sexual intercourse does not cause a miscarriage.)
Lastly, some vaginal bleeding could be a sign of implantation if it’s very early in your pregnancy—within the first six to 12 days after fertilization. Implantation bleeding is believed to happen when the fertilized egg attaches to the lining of the uterus. It doesn’t happen to everyone, but if timing coincides, you might experience light bleeding after sex, as a result.
Here’s the general rule of thumb: If the bleeding is light and takes place during the first half of your pregnancy, you probably don’t need to contact your doctor or OB/GYN.
If the bleeding is medium to heavy, or if you experience even a small amount of bleeding during the second half of your pregnancy, give your provider a call. They will likely check you for placenta previa or placental abruption, both high risk conditions that may develop later in pregnancy.
POST-MENOPAUSAL BLEEDING AFTER SEX
Individuals who have gone through menopause and are bleeding during or after sex should reach out to their healthcare provider ASAP. Vaginal bleeding anytime after menopause is not normal and certainly warrants additional testing to rule out possible underlying problems, which range from benign polyps to cervical or uterine cancer. 8
If an underlying condition has been ruled out but you are still experiencing bleeding during or after sex, decreased estrogen levels—which are to be expected after menopause—could be to blame. Lower estrogen tends to correlate with vaginal dryness. In addition, as you age, the tissue of your vulva and vagina begins to thin out. This thinner, more sensitive skin is more prone to tearing or abrasion, so make sure to use plenty of lube to avoid bleeding with sex.
We’ll say it louder for the seats in the back: When in doubt, reach out! Unexpected vaginal bleeding shouldn’t be taken lightly, and that includes bleeding during or after sex (when you know it isn’t your period). There are a few exceptions, of course—like if it’s your first time having penetrative sex, or if you’ve just had an IUD inserted—but we’d rather you err on the side of caution.
If you’ve talked to a healthcare provider and already know it’s just good ‘ol friction to blame for your postcoital bleeding, invest some more time into foreplay the next time you hop in the sack and consider adding a water-based lubricant to the mix (and don’t be afraid to apply with a heavy hand!).
This article is informational only and is not offered as medical advice, nor does it substitute for a consultation with your physician. If you have any gynecological/medical concerns or conditions, please consult your physician.
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