Bleeding After Sex – Is It Normal?

Ever gone to the bathroom after sex, or looked down at your fresh white sheets, and noticed a bit of blood? Seeing blood after sex may be alarming, especially if you aren’t on your period. Is it something to worry about? 

Known as “postcoital bleeding,” bleeding after sex may be caused by a plethora of reasons. And while most of the time it’s nothing to worry about, it’s something to pay attention to. 

Postcoital bleeding isn’t linked to your period and typically isn’t painful. If you have pain during or after sex, you may have another condition like vaginismus or low estrogen levels. 

We dive into the causes of bleeding after sex and when you should seek advice from a health professional. 

Pelvic Inflammatory Disease or an STI

Having an inflamed cervix, called cervicitis, can cause bleeding after sex. An inflamed cervix may be due to an infection or an STI like chlamydia, gonorrhea, or Pelvic Inflammatory Disease (PID). 

If you experience an odor, itching, pain, or burning sensation, contact your doctor immediately for an STI test. 

Vaginal Dryness and Tearing

If you’ve just had rough, deep, or long-lasting sex, you may notice blood. This is because you’ve probably experienced minor tearing of the vaginal walls. This may be because of a lack of lubrication but could also be due to long fingernails (so make sure your partner is trimming and keeping you safe!). 

If you’ve experienced a vagina laceration, the bleeding is usually short-term and the blood is bright red. 

When a woman is in perimenopause, which is the years leading up to menopause, estrogen levels begin to rapidly drop. This causes atrophy and vaginal dryness, leading to more chances of bleeding after sex. 

It’s recommended to always use lube — no matter what your age — during sex, as it reduces your chances of tearing and dryness, and makes sex feel better in general. Use a water-based lube when using a condom or silicone sex toy, or a silicone-based lubricant if you’re looking for long-lasting lubrication. 

For a post-menopausal woman, a doctor may prescribe an estrogen cream since the vaginal lining is thin and prone to inflammation, bleeding, and intense pain during sex. 

Other reasons for vaginal dryness include breastfeeding, allergies, antidepressants, perimenopause, cancer treatment, over-douching, and stress. 

IUD

After having your IUD inserted, you may notice some light bleeding. Some people have even reported that they’ve experienced bleeding upwards of a few months after insertion as the body adjusts. Sex may irritate or jostle the IUD which can result in bleeding as well. 

If you’ve noticed any changes with your IUD — pain or discomfort for your partner — visit your doctor to make sure the IUD has not been dislodged. 

Benign Growths

Typically one to two centimeters in size, cervical polyps, are non-cancerous and benign growths on the cervix. During intercourse, polyps may bleed. A doctor can remove them during a polypectomy during your yearly Pap test. 

Strenuous exercise or activity — like sex — can rupture a cyst, where you may require surgery but oftentimes, the cyst dissipates on its own. 

Another growth is uterine fibroids, which can grow as large as a melon, and put pressure on the uterus. You will typically feel pain during sex if you have a fibroid, and many women experience bleeding after sex if they have a fibroid. 

Cervical Erosion

Although scary sounding, cervical erosion, or cervical ectropion, is common and harmless. It’s not linked to any type of cancer and happens when cells from inside of the cervical canal grow on the outside of the cervix. 

Impacting anywhere from 17% to 50% of people, cervical erosion may be something you are born with or it may occur because your body has been exposed to estrogen. 

Anywhere from 5% to 25% of women with cervical erosion experience postcoital bleeding because the fine blood vessels in the inner lining of the vagina are torn very easily during sex. 

People taking contraceptives, people who are pregnant, or adolescents have higher levels of estrogen and typically experience this condition. 

Cancer

Although rare, bleeding after sex may be a sign of cervical cancer, which kills about 4,000 women in the United States every year. If you have cervical cancer, the blood is usually foul-smelling and pink or brown. 

Other symptoms of cervical cancer include bleeding between periods, having longer periods than normal, watery discharge that has a strong odor, and pain during sex. 

Make sure to visit a healthcare provider for your annual Pap test to screen for cervical cancer and the human papillomavirus (HPV). 

How To Get Tested and Treated for Bleeding After Sex

Usually, your doctor will conduct a few tests to rule out certain concerns. A pregnancy test will usually be conducted as well as a pelvic examination. Additionally, a doctor may insert a speculum to look at the cervix. 

If the bleeding occurs from vaginal dryness, a doctor will recommend a lubricant. 

How To Talk To Your Partner About Bleeding After Sex

Talking to your sexual partner is key in connecting and ensuring that you won’t be alone in discovering what could be wrong. Here are a few tips when discussing bleeding after sex. 

• Talk with your partner about potential complications. 
• Experiment with different sex positions and discuss what feels good with your partner. 
• Encourage play before intercourse to warm up the body. Make sure you have enough lubrication and make sure your partner understands that introducing lube can create pain-free, blood-free sex. 

​​In addition to talking with your partner, visit your doctor to rule out any serious health complications that may be leading to bleeding after sex. Keep in mind when you bleed, how much you bleed, and how often, and let your doctor know when you go in for your visit. They will help rule out any long-lasting issues and ensure you’ll have a healthier sex life. 

While we won’t say it’s “normal,” to bleed after sex, it’s usually not a life-threatening situation. At the end of the time, only a professional can help you take the steps to reduce a crimson tide post-sex.