"There’s no worse post-sex feeling than going to the bathroom and looking down at your underwear to find a spot of blood. You quickly think to yourself, “Am I on my period?” and when the answer is no, you start panic-searching and land on WebMd, only to read about the absolute worst-case, no-chill scenarios. But is there reason to panic, or is it normal to bleed after sex?
Bleeding after sex is actually an extremely common occurrence. And although in most cases it’s perfectly harmless, in other cases, it has the potential to lead to some tricky issues. We sat down with a few trusted doctors to ask as many questions as we could about post-coital bleeding so that next time, you won’t have to resort to Google.
What are the different reasons we might bleed after sex?
There are a ton of different reasons why someone might experience bleeding after sex, and these reasons can range from something as harmless as vaginal dryness to something more severe. This is why it’s important to educate ourselves on the topic as much as we can and talk to a professional when needed.
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Vaginal dryness or inflammation
Listen, being sensitive doesn’t make you weak, and the same applies to our vaginas. Our vaginas are powerful, but the delicate balance of healthy bacteria down there can make them, as well as the surrounding vulva area, a bit sensitive.
“For people who are receiving penetrative sex (meaning something is being inserted into the vagina), bleeding can happen as a result of stretching or scratching of the vaginal surfaces,” said Melissa L. Wong, M.D., OB/GYN at Boston Medical Center.
And if you have any of these cuts, scratches, or small abrasions in or around your vagina, your body may not be producing as much fluid as usual.
“Vaginal dryness can lead to small abrasions after intercourse, and these may bleed,” said Dr. Lauren Demosthenes, senior medical director at Babyscripts. “So if you experience vaginal dryness, using a lubricant with intercourse may definitely help.”
According to Dr. Nicole Williams, Chicago gynecologist and author of This Is How You Vagina: All About the Vajayjay and Why You Probably Shouldn’t Call It That, if you don’t really experience any vagina dryness when having sex, inflammation might also be a cause of bleeding.
“Generally, I find women who bleed after sex, unassociated with menstruation, will usually have inflammation of the cervix or vagina, which is usually just treated with a topical antibiotic for several days,” Dr. Williams said.
Vaginal infection
Like I mentioned earlier, vaginas house a balanced system of “good” and “bad” bacteria that keep us healthy. But when this balance gets knocked out of whack, it can lead to a vaginal infection.
One of the most common vaginal infections is a yeast infection. This can occur when your antifungal bacteria is off balance, which allows for an overgrowth of a fungus called candida (a type of yeast).
Now before you get too grossed out by the thought of a fungus in your body, you should know that we actually have yeast in our bodies at all times, and it’s actually very healthy. Only when there’s an overgrowth is there a problem.
A common symptom of yeast or vaginal infection is itching, which can sometimes be severe. “Vaginal infections can cause a lot of itching, and scratching down there may lead to bleeding,” Dr. Demosthenes said.
Period-related bleeding
According to Dr. Williams, it’s also possible that you might experience period-related bleeding after sex, even after your period is over.
“If you are at the end of your menstrual cycle, you may experience some bleeding after sex due to some leftover tissue in the uterus,” Dr. Williams said.
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STIs
Certain types of STIs may also lead to post-coital bleeding. “Vaginal or vulvar lesions like herpes or syphilis may bleed after contact during sex,” Dr. Demosthenes said. “And other STIs like chlamydia and gonorrhea can cause an abnormal discharge and some light bleeding.”
Dr. Demosthenes noted that whether you have vaginal bleeding or not, getting screened for STIs is crucial when engaging with any new sexual partners.
Polyp
According to Dr. Wong, bleeding after sex may be a sign of something a bit more abnormal, “such as the growth of a polyp or mass.”
Cervical polyps are growths that can be found on the edge of the cervix where it meets the vagina, and although they’re usually benign, it’s always a good idea to get them looked at in case.
“A polyp on the cervix or in the uterus can also cause persistent bleeding, and these can usually be removed in the office or as an outpatient procedure if necessary,” Dr. Demosthenes said.
Cervical cancer
In rare cases, bleeding after sex can be a sign of a more serious issue. “Cervical cancers and cancers of the uterus may also lead to bleeding after intercourse, so people who are not up to date on their pap smears should have this checked out as soon as possible,” Dr. Demosthenes said.
Endometriosis
A uterus naturally has tissue that grows inside and forms a lining along its walls, which is why we bleed during our periods. Endometriosis is a problem that can occur when tissue begins to form on the outside of the uterus, causing a lot of pain, heavy cramps, and sometimes chronic fatigue. A very common symptom of endometriosis is bleeding after sex.
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What to do if you bleed after sex
The first thing to do is try your best not to panic because chances are, you may just need to load up on some lube next time you have sex. However, it’s important to be aware of your body in these moments, and whether or not you see a doctor should depend on how often the bleeding occurs, how much blood there is, and if there is pain along with it.
“If bleeding after sex happens once in a while and is no heavier than spotting, it’s probably normal,” Dr. Wong said. “But if you consistently bleed after sex, you feel pain after sex, or if the bleeding becomes heavy like a period, you may want to talk to your health care provider to make sure there’s nothing abnormal going on.”
If there’s any doubt in your mind, it never hurts to go get a check-up for peace of mind. Besides, knowing that everything is OK down there can help us be fully present and have way more enjoyable sex!