Bleeding after sex can be scary, but that doesn’t mean you should panic. It can happen for various reasons. What many people don’t understand is that bleeding after sex doesn’t just happen when you “pop your cherry” or break the hymen, which is a crescent- or ring-shaped piece of tissue at the opening of the vagina. In fact, the idea that the hymen tears when you lose your virginity is largely a myth, and even when the hymen is damaged as a result of penetration, it’s just one of the many reasons why you may experience bleeding after intercourse. sex, no matter what. how long you have been sexually active
obstetrician-gynecologist cataline bevanMD, division director for Texas Health Care, explains that postcoital bleeding can occur due to a number of conditions, from sexually transmitted infections (STIs) to vaginal dryness. You may even experience bleeding if your partner is too large or after particularly vigorous intercourse, which can cause small cuts or tears in the vagina.
Although bleeding after sex is normal, it’s not something you should ignore, regardless of whether you’re in pain or not. Many of the conditions that can cause postcoital bleeding require testing and treatment. Read on to learn more about the most common causes of bleeding after sex and when experts recommend talking to your doctor.
Is it normal to bleed after sex?
It can absolutely be normal to bleed after sex, says Dr. Bevan, though it’s never a bad idea to point out your symptoms to a doctor. Factors such as your sexual history and age can often help identify a cause: Do you regularly use a condom? Are you in menopause? Did you recently start having penetrative sex for the first time?
While an isolated incident is usually not a cause for concern, it’s important to make an appointment with your OB-GYN if the bleeding you’re experiencing after sex is persistent, worsening, or heavy or if you have pelvic pain, cramping, fever, or a history of abnormal Pap smears. Heavy postcoital bleeding after sex or a fever above 100.4 deserves immediate attention, as it could be a sign of infection, he says allison canavanMD, FACOG, a board certified obstetrician-gynecologist in California.
Tests may include a pelvic exam, STI screening, a PAP testand sometimes imaging, such as an ultrasound or CT scan, depending on your symptoms.
Causes of vaginal bleeding after sex
These are the most common reasons why you may experience postcoital bleeding, according to experts.
tearing the hymen
Damage to the hymen can result in a small amount of bleeding, according to a Georgia-based obstetrician-gynecologist. Dr Jennifer Kaby, MPH. While this can happen the first time you have penetrative sex (or later, if the partner is of a larger girth), the hymen can also be stretched or torn. using tampons or even ride a bike. Regardless of how it happens, this spotting is usually not a cause for concern and will usually heal on its own. But if you’re concerned, talk to your healthcare provider about your specific symptoms.
sexually transmitted infections
“Postcoital bleeding can occur with sexually transmitted infections, particularly any that cause irritation of the cervix, such as gonorrhea, chlamydia, or even trichomoniasis,” explains Dr. Canavan. He adds that genital herpes sores can also cause vaginal bleeding if they’re severely irritated, although this is unlikely. If he thinks he may have contracted an STI, it’s important to see his doctor. If left untreated, an STI can develop into pelvic inflammatory disease (PID), so get tested regularly and watch for the telltale signs, including yellow or green discharge, vaginal burning either smelland pelvic pain.
Pelvic inflammatory disease
“Pelvic inflammatory disease is an infection involving the cervix, uterus, and surrounding organs that often leads to significant pelvic pain and cramping, as well as bleeding after intercourse,” Dr. Canavan tells POPSUGAR. PID is usually caused by untreated STIs such as chlamydia and gonorrhea, however PID can also be caused by infections that are not sexually transmitted, such as those that can result from douching.
vaginal dryness it can also result in bleeding after sex. Sometimes using more lubricant you can fix this problem; other times, it could occur due to a drop in estrogen levels. “This is somewhat more common in breast-feeding patients, where estrogen levels are very low, as well as in menopausal and postmenopausal patients, since the ovaries don’t produce as much estrogen as they used to,” explains Dr. Bevan. If you’re postmenopausal and have vaginal bleeding, Dr. Bevan recommends getting a vaginal ultrasound right away to rule out uterine cancer. Whichever reproductive stage you’re in, it’s best to talk to your doctor if you’re experiencing vaginal dryness. Depending on the cause, your doctor may prescribe vaginal estrogen in cream or tablet form, or suggest lubricants that can help make intercourse less painful.
Cervical or Endometrial Polyps
Polyps are one of the culprits that can cause a lot of bleeding after sex. “A cervical or endometrial polyp is a benign growth of the cervical stroma or endometrial tissue,” says Dr. Kaby. “This overgrowth or bulging of tissue makes the small vessels within the polyps less protected. When friction or mechanical contact occurs, they bleed.”
If you’re having a hard time understanding what a polyp is, picture them as tiny skin tags on the cervix or lining of the uterus, says Dr. Bevan. These “skin tags” have a feeding container that helps them grow. When they rub against each other during sexual intercourse, they become irritated and consequently bleed. While your doctor can remove most cervical polyps in the office, Dr. Canavan says that endometrial polyps may require a minimally invasive procedure, such as a hysteroscopy, which uses a small camera to look inside the uterus.
Friable cervix is a medical term used to describe cervical tissue that is extremely sensitive. Its brittleness means it is more prone to irritation, discomfort, postcoital bleeding, and even tearing after penetration. Dr. Kaby explains that a friable cervix often stems from infections caused by a pH imbalancesuch as bacterial vaginosis or a thrush. If you’re experiencing symptoms of an infection, such as unusual discharge, itching, or burning, it’s time to make an appointment.
Cervical dysplasia is a precancerous condition that occurs when abnormal cells grow on the lining of the cervix, says Dr. Canavan. Symptoms of cervical dysplasia, while not always present, can include painful sex, bleeding after sex, and excessive discharge. Cervical dysplasia is found on a Pap smear, which is why it’s so important to stay on top of your well exams.
“Please, please, please don’t fall asleep on this! If you have a history of abnormal Pap smears or have been late getting your Pap smear, visit your gynecologist as soon as you can,” says Dr. Canavan. You may catch something before it has a chance to become cancerous.
Can you bleed if your partner is too big?
Although it’s possible to bleed if you have sex with someone who has a larger penis, it’s not very common, says gynecologist Kirti Patel, MD, medical director of the point of viewan online women’s health resource. “It’s possible to cause trauma due to a mismatch in vagina and penis size between couples, but we don’t see that often,” says Dr. Patel. “Usually the pain and discomfort that would make most people stop having sex before serious injury occurs.” That said, if your sexual partner has a larger penis, you may find that using more lube or spending more time foreplay could help with this problem.
And ultimately, if you’re worried about bleeding after sex for any reason, it’s a good idea to see a doctor or medical professional. They will be able to assess the problem, address your specific symptoms and concerns, and recommend the best treatment and/or relief method.
—Additional reporting by Taylor Andrews
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