Bleeding After Sex: What You Should Know

Vaginal bleeding or spotting that occurs after intercourse is known as postcoital bleeding. Bleeding after sex can happen as a result of menstruation, vaginal dryness, inflammation, infection or cervical problems. Most of the time, it’s nothing serious. But bleeding after sex can sometimes signal larger issues, especially if it’s happening consistently.

7 Reasons You’re Bleeding After Sex

Postcoital bleeding isn’t uncommon but it could have several causes.

Ashley Mateo has over a decade’s worth of experience covering fitness, health, travel, and more for publications including the WSJ, Men’s Journal, Women’s Health, and more.

Updated on November 23, 2022
Medically reviewed by

Layan Alrahmani, MD, is an OB/GYN, Assistant Professor, and Maternal Fetal Medicine specialist with a focus on the care of high-risk pregnancies.

Having sex naturally involves bodily fluids, but blood isn’t a fluid you want to see on your sheets. Vaginal bleeding or spotting after sex—medically known as postcoital bleeding—can be concerning, but it’s usually not a medical emergency. Here are some reasons you might experience vaginal bleeding after sex.

Frequency of Post Sex Bleeding

“A small amount of spotting is probably normal and fine if it happens one time or on a rare occasion,” Nichole Mahnert, MD, an OB-GYN at Banner University Medical Center Phoenix, told Health. But if post-sex bleeding happens more than once, it’s time to check in with your healthcare provider.

Students who make it into medical school pay a lot of money for the privilege of eventually becoming a doctor, with medical school students in the class of 2019 graduating with an average of $201,490 in student debt, according to the Association of American Medical Colleges as reported by Nerd Wallet. That’s an increase of 2.5% from 2018.

Some health concerns like an infection or cervical cancer can also cause bleeding after sex. “Most causes are not dangerous, but a few are,” Felice Gersh, MD, an OB-GYN and the founder and director of the Integrative Medical Practice of Irvine, told Health.

If you have a vagina bleeding after sex it isn’t related to period blood. Anyone can deal with bleeding after sex including people who are still menstruating, no longer have a period, or have entered menopause. You may notice red spots on the bed, on your underwear, or between your legs after sex.

Vaginal Dryness

If your vagina is not well lubricated, friction during penetrative sex can tear sensitive vaginal tissues and lead to bleeding, said Dr. Gersh. This can also make sex uncomfortable or painful. Vaginal dryness is typically caused by:

• Hormonal changes: Dropping estrogen levels after giving birth, while breastfeeding, during perimenopause, and after menopause can lead to vaginal dryness.
• Having sex before you’re aroused: The friction can lead to micro-tears in your vaginal tissue.
• Chemotherapy: Chemotherapy can damage your ovaries so that they no longer produce estrogen and progesterone, which can also lead to vaginal dryness.

You can help restore moisture to your vagina and avoid sex-related pain or bleeding. Your healthcare provider can talk to you about options that include lubricants, moisturizers, and vaginal estrogen, depending on the cause of the dryness.

Birth Control

Any type of hormonal contraceptive can lead to spotting after intercourse, said Dr. Mahnert. Spotting between periods, or breakthrough bleeding typically happens when you start a new hormonal birth control. It’s even more common if you’re on low-dose or ultra-low-dose birth control pills, have an intrauterine hormonal device (IUD), or have an implant.

After a few months, your body will usually adjust, and breakthrough bleeding will stop. However, bleeding doesn’t always go away, especially if you have the implant. Some people using hormonal birth control may also experience vaginal dryness. This may cause tearing and some bleeding after sex.

Talk to your healthcare provider if you think your birth control is the cause of your post-sex bleeding. They may recommend alternative birth control methods.

Sexually Transmitted Infections

Sexually transmitted infections (STIs) can cause post-sex bleeding—especially if the infection leads to an inflammation of the cervix, called cervicitis. “A very irritated cervix can bleed with rubbing,” said Dr. Gersh.

STIs like chlamydia, gonorrhea, trichomoniasis, and herpes can cause cervicitis. So if you have one of these STIs, sex can irritate your cervix—the area between your vaginal canal and uterus—and cause bleeding.

Gonorrhea and chlamydia can also lead to pelvic inflammatory disease (PID), an infection of the reproductive organs. This infection can cause bleeding between periods, bleeding after sex, pelvic pain, and unusual discharge and odor. Untreated PID can also lead to scar tissue and infertility.

“Most [people] do not have symptoms of STIs, which is why it’s important to seek treatment when you do have a symptom like abnormal bleeding,” said Dr. Manhert.

Uterine and Cervical Polyps

Polyps are teardrops of tissue that form in the reproductive tract on the cervix or inside the uterus. “They have many blood vessels feeding them and can bleed if bumped around, so you’d see small amounts of blood after intercourse,” said Dr. Gersh.

Cervical polyps can hang down from the cervix into the vagina, where they might get touched or hit during sex. Since your uterus is connected to the cervix, polyps inside your uterus may also become irritated during sex.

Anyone can have polyps, but they’re more common in people who are older than 40 or have entered perimenopause—the transitional period before menopause. Both uterine (aka endometrial) and cervical polyps are usually benign, meaning they are non-cancerous growths. But in rare cases, these polyps can turn into endometrial and cervical cancer.

Chat with your healthcare provider if you think a polyp is to blame for any blood you see after sex. Treatment isn’t always necessary, but depending on their size and your symptoms, you may need surgery.

Bacterial Vaginosis or Yeast Infection

“Any kind of infection can cause inflammation and irritation, which can result in bleeding,” said Dr. Mahnert. Bacterial vaginosis (BV), which is caused by an overgrowth of bacteria, is the most common vaginal infection in people between 15 and 44 years old. Most people with vaginas will also experience at least one yeast infection in their lifetime.

Symptoms of BV can include:

• White or gray discharge
• Itching
• Burning
• A fishy vaginal odor
• Swelling

That said, bleeding isn’t the most common symptom with bacterial vaginosis or a yeast infection. Most people with BV don’t have any symptoms. “But if the cervix is infected and becomes inflamed, aka cervicitis, there could be some small amounts of blood seen after sex, due to the rubbing,” said Dr. Gersh.

Uterine Fibroids

Fibroids are a non-cancerous growth made from the uterus’ muscular tissue. A fibroid typically grows out of the uterine wall and can be as small as a pea or larger than a grapefruit. “Fibroids can cause bleeding when they are all or partially within the uterine cavity,” said Dr. Gersh. “They have a lot of blood in them, and with the bouncing movements of sex, they can begin to bleed.”

If you have a vagina, fibroids are the most common growth found in the pelvis. In fact, more than 75% of women will have fibroids at some point in their reproductive years. You’re more at risk of developing fibroids if you’re between 30 and 40 years old. Black people with vaginas are also more likely to deal with fibroids than white people.

Most people don’t know they have a fibroid. And even if you are diagnosed with one, treatment usually isn’t necessary unless the fibroid grows too large. If that does happen, your healthcare provider may consider treatment options, including medication or surgery to remove the fibroid.

Cervical Cancer

Cervical cancer is cancer of the cervix – the area between your vaginal canal and the bottom of your uterus. Bleeding with sex is the main symptom of cervical cancer. “The bleeding is typically light and painless,” said Dr. Gersh. It’s due to the vascular nature of cervical cancer and that the friction of sex can irritate tissue and cause bleeding.” The good news is cervical cancer is highly treatable if found early, thanks to screening tests like the Pap smear.

The HPV (human papillomavirus) test also looks for high-risk types of HPV that can lead to cervical cancer. Thousands of new cases are diagnosed in the U.S. each year, and folks can still die from cervical cancer if not found and treated. You’re more at risk of developing cervical cancer if you’re 30 years old or older.

Still, if you have abnormal bleeding regularly, tell your healthcare provider ASAP. They’ll want to examine your cervix closeup and ensure you’re up to date with your Paps and HPV testing.

A Quick Review

Bleeding after sex on occasion usually isn’t a big deal. Friction from sex, especially if your vagina is dry, can cause tearing and bleeding. But if you consistently notice vaginal bleeding after sex, or have any pain during sex, talk to your healthcare provider. If vaginal dryness is to blame, they may recommend using a vaginal moisturizer, hormonal treatments, or a personal lubricant to help reduce friction and make sex more comfortable.

It is possible that post-sex bleeding is related to a more serious infection, STI, or cancer. Any time you notice abnormal discharge, odors, bleeding, or pain, you could have a health condition that needs treatment. Visiting your healthcare provider can help you rule out what’s causing any bleeding after sex.

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Bleeding After Sex: What You Should Know

Vaginal bleeding or spotting that occurs after intercourse is known as postcoital bleeding. Bleeding after sex can happen as a result of menstruation, vaginal dryness, inflammation, infection or cervical problems. Most of the time, it’s nothing serious. But bleeding after sex can sometimes signal larger issues, especially if it’s happening consistently.

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Ob/Gyn Philip Brzozowski, MD, explains some of the more common reasons why you may be bleeding after you have sex and when treatment is necessary.

Common causes for bleeding after sex

Vaginal bleeding might occur if your hymen breaks, from either vaginal intercourse or other means. When this happens, this is normal, but it’s different from postcoital bleeding. Postcoital bleeding is related to a number of conditions that are infectious or noninfectious.

“With infectious causes, we’re always concerned about genital tract infections,” says Dr. Brzozowski. “For noninfectious causes, doctors are concerned about vaginal atrophy, cervicitis and other cervical conditions.”

Here are seven common causes of postcoital bleeding:

Menstruation

This may seem obvious, but before you call your doctor, consider whether it’s around that time of the month. “If you have sex right before or after your period, that may explain your bleeding,” says Dr. Brzozowski. Keeping track of your cycles with a menstrual calendar is helpful for resolving such questions and understanding more about what’s happening during your menstrual cycle.

Vaginal atrophy or dryness

Also commonly referred to as vaginal dryness, vaginal atrophy is a condition where the lining of your vagina gets drier and thinner, typically because of a lack of estrogen. People of all ages can experience vaginal atrophy, though it most often shows up after menopause. “If dryness is severe, the friction of intercourse may cause bleeding,” Dr. Brzozowski explains. “Using lubrication during sex may help, but if estrogen is the issue, your doctor may recommend hormone replacement therapy in pill, insert or cream form to replace what was previously lost.”

Cervicitis

Cervicitis is the inflammation of the cervix, often as the result of infections or irritation. This condition may cause bleeding or a change in vaginal discharge. Possible causes include:

• Sexually transmitted diseases, such as chlamydia, gonorrhea or trichomoniasis.
• Bacterial vaginosis, or an imbalance of the naturally occurring bacteria in the vagina. While this isn’t a likely cause, sometimes, secondary inflammation can cause bleeding after sex.
• Chemical irritation from spermicides, douches or latex in condoms.

Although the bacterial and viral infections that cause cervicitis are contagious, this condition can be treated with antibiotics or antifungals.

Cervical ectropion

With cervical ectropion, the soft, glandular cells that line the inside of your cervical canal expand into the outer part of your cervix (where the cells are typically harder), almost as if it’s turning itself inside out. This is a normal condition for many people with a cervix and usually doesn’t require treatment. But if there are symptoms, such as excessive discharge or bleeding, it could require outpatient heat or cold therapy to treat the area and stop the bleeding.

“If you have bleeding or pain from cervical ectropion that interferes with your sex life, your doctor may recommend treatment,” says Dr. Brzozowski.

Cervical polyps

These are growths on the opening of your cervix that sometimes result from chronic inflammation or hormonal changes. Almost all cervical polyps are benign. If your symptoms are minor, you may not need treatment. Sometimes, with irregular bleeding, there’s a small chance of abnormal cells developing. In these cases, your polyps are removed and sent for evaluation to make sure those cells are benign.

Uterine prolapse

If your uterus comes out of its normal position, your cervix and other tissues are sometimes exposed. Symptoms of this condition include pelvic pain, abdominal pain or lower back pain and pain during sex. If your uterine prolapse is severe enough, it may cause bleeding.

For a minor prolapse, your doctor may recommend weight loss or Kegel exercises to strengthen muscles in the area. In more severe cases, your doctor can insert a ring to support the tissue or perform surgery to repair it.

Cervical cancer

About 11% of people who have cervical cancer have postcoital bleeding, according to Dr. Brzozowski. In fact, it’s often the first symptom of cancer and one of the things you’re probably most worried about.

“Cervical cancers are preventable in most cases as long as you follow up with your gynecologist and have a routine screening done,” notes Dr. Brzozowski. “Cervical cancer tends to be very slow-growing over many years.”

If you’re diagnosed with cervical cancer, your doctor will refer you to a gynecologic oncologist for further management. A simple outpatient treatment can remove abnormal precancerous cells. If the cells are cancerous, your gynecologic oncologist will likely recommend chemotherapy, radiation, surgery or a combination of treatments depending on your condition.

Is bleeding after sex normal?

A good rule of thumb is that any abnormal bleeding, whether it’s just a few drops or a large amount, needs to be evaluated, Dr. Brzozowski says.

“If you are experiencing something that isn’t normal, it’s not necessarily bad, but if it is consistently happening or you are just concerned, get it checked out,” he adds.

During your visit, your doctor go over your medical history and ask you about:

• Other irregular bleeding.
• Heavy or irregular periods.
• Unusual pain that doesn’t seem to relate to the bleeding.
• A change in sexual partners.
• A change in vaginal discharge.
• When you had your last Pap test.

A physical exam will check for signs of infection. If your Pap test isn’t current, your doctor can perform one for you while you’re in their office. A Pap screening can help determine the need for any further tests or procedures.

If your testing shows no problems, but your bleeding continues — and it only occurs after sex — your doctor will likely want to check your cervix and do a biopsy. This may show any underlying condition that a physical exam and Pap smear didn’t find.

“The important thing to remember is that most of the time, it is nothing serious,” Dr. Brzozowski says.

How to stop bleeding

It’s important to treat the underlying cause behind your postcoital bleeding if treatment is required. Depending on the cause, your doctor may advise any of the following solutions to prevent postcoital bleeding in the future:

• Keep track of your menstrual cycle and wait a few days after your period has ended before you have sex.
• Continue having routine screenings and Pap tests to check for cancer and other conditions.
• Use a lubricant before and during sex if you experience dryness.
• Refrain from having rough sex.
• Have your doctor prescribe antibiotics or other treatments if you have an infection.
• Have your doctor remove cervical polyps or treat other abnormalities as needed.

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Vaginal Bleeding After Sex

Tracee Cornforth is a freelance writer who covers menstruation, menstrual disorders, and other women’s health issues.

Updated on September 29, 2022

Monique Rainford, MD, is board-certified in obstetrics-gynecology, and currently serves as an Assistant Clinical Professor at Yale Medicine. She is the former chief of obstetrics-gynecology at Yale Health.

Table of Contents
Table of Contents

Bleeding during or after sex is common and not always a reason to worry. As many as 9% of people have experienced vaginal bleeding after sex that was not related to their menstrual period. It’s also called postcoital bleeding .

Between 46% and 63% of postmenopausal people will experience dryness, itching, tenderness, or bleeding during or after sex that’s related to hormonal changes affecting the vaginal tissue.

This article will go over seven common reasons for bleeding during or after sex. While many of the causes are not serious, it’s still a good idea to let your healthcare provider know if you are bleeding outside of your typical menstrual cycle.

Sexually Transmitted Infections

Sexually transmitted infections (STIs) like chlamydia and gonorrhea are associated with vaginal symptoms like pelvic pain, itching, burning, vaginal discharge, and frequent, painful urination.

Each STI has its own symptoms, but the inflammation from any infection can cause vaginal bleeding. For example:

• Trichomoniasis is caused by a single-celled parasite. Cervical discharge and cervical bleeding are two of the most common symptoms of the disease.
• Syphilisand genital herpescause open sores that may bleed if irritated. The sores often appear on the outside (externally) but they can also develop inside the vagina. The sores can be painless and may go unnoticed until they bleed.

STIs need to be diagnosed by a healthcare provider. They will talk to you about your sexual history and do some tests to check for STIs. The treatment for STIs depends on what is causing them. For example, you may need to take antibiotics or antiviral medications.

You can also prevent STIs by practicing safe sex and getting vaccinated against some infections, like hepatitis B.

Benign Polyps

Benign growths on the cervix ( cervical polyps ) or uterus (uterine or endometrial polyps) are common causes of bleeding during or after sex.

• Cervical polyps tend to develop in people who are in their 40s and 50s and who have had multiple pregnancies. The polyps are typically red or violet with a tube-like structure that has a lot of capillaries and can bleed easily when touched.
• Uterine polyps are small, soft lumps of tissue protruding from within the uterus. They are prone to bleeding between periods, during sex, and after menopause. They tend to develop in people between the ages of 36 and 55.

Most polyps are not cancer (benign) but some can develop into cancer. Your provider can diagnose the polyps and test them to see if they could be cancerous. Polyps sometimes go away without treatment, but surgical removal might be necessary in some cases.

There are also noncancerous growths in the genital tract, such as a hemangioma (a tumor made up of blood vessels), that can cause postcoital bleeding. However, these growths are less common causes of bleeding during or after sex.

Cervical Ectropion

Cervical ectropion is a noncancerous condition where the cells that normally line the inside of the cervix protrude outside through the opening of the cervix (cervical os).

This can cause the already-fragile blood vessels in the cervix to dilate and become inflamed. As a result, bleeding is common with intercourse, the use of tampons, and the insertion of a speculum during a pelvic exam.

Cervical ectropion can occur in adolescents, people taking birth control pills, and pregnant people whose cervixes are softer than normal.

Your provider can diagnose cervical ectropion by doing an exam. The condition usually does not require treatment unless there is excessive vaginal discharge or bleeding.

Atrophic Vaginitis

Postmenopausal people often bleed during or after sex because decreasing estrogen levels in their bodies cause the walls of their vaginas to thin and produce less lubricating mucus. This is referred to as atrophic vaginitis . The condition usually causes vaginal itching and burning.

Younger people can also have vaginitis, often from a bacterial or yeast infection. However, postcoital bleeding is not usually a symptom of these conditions.

A healthcare provider can usually diagnose vaginitis by doing an exam. They can also test a sample of fluid from inside the vagina (culture) to check for an infection.

Atrophic vaginitis can be treated with estrogen therapy. It can be taken orally in pill form, applied to the skin as a patch or cream, or inserted vaginally as a suppository.

However, oral estrogen replacement therapy does have downsides. For example, estrogen-only pills can increase the risk of endometrial cancer in people who still have their uterus. The pills should be used as a short-term treatment or combined with progestin to protect the lining of the uterus.

Vaginal lubricants can often ease dryness and decrease pain related to vaginitis.

Endometriosis

Endometriosis occurs when cells that are similar to those that make up the lining of the uterus (the endometrium) grow outside of the uterus. The endometrial tissue can attach to the surfaces of other organs and cause excruciating pain. Some people with endometriosis also experience infertility.

There is a range of symptoms of endometriosis depending on which organs are affected by it. For many people with the condition, painful intercourse, painful orgasms, and postcoital bleeding are common.

It can be difficult to diagnose endometriosis. A provider will talk with you about your symptoms and might want to do a surgery called a diagnostic laparoscopy to look for lesions. They can also take a sample of tissue to look at under a microscope and confirm the diagnosis.

Treatment for endometriosis can include medications and surgery. Hormone therapy to reduce estrogen levels reduces pain for some people with endometriosis and others find relief when they have surgery to remove the lesions.

If you have endometriosis and experience pain or bleeding during sex, changing positions may help. For example, the missionary position can place added stress on the vagina and cause pain. A side-to-side position might be more comfortable.

Trauma

Postcoital bleeding is often associated with infections and abnormalities of the uterus, vagina, or cervix, but bleeding can also because when these vulnerable tissues are injured.

For example, vigorous sex can lead to cuts, scrapes, or tears on the vagina. This is more likely to happen when the vagina is dry (for example, during menopause, breastfeeding, or from excessive douching).

Bleeding can also be caused by sexual abuse or violence. For example, forced penetration can severely damage vaginal tissues and lead to fissures. The wounds can repeatedly heal and reopen unless they are medically treated.

Cancer

While cancer is a less likely cause of postcoital bleeding, this symptom is one of the possible signs of cervical, vaginal, and uterine cancer.

Cervical Cancer Stats

Nearly 15,000 people are diagnosed with invasive cervical cancer in the United States every year, leading to more than 4,000 deaths.

The tumors can vary depending on the type of cancer. The blood vessels that supply them can burst when the tumor gets bigger, which can lead to bleeding. Sometimes, the bleeding is triggered by sex but can also happen at other times.

Other symptoms that are common with cancer of the reproductive system include:

• Bleeding after menopause or between menstrual periods
• Heavy or longer-than-usual periods
• Vaginal discharge streaked with blood (sometimes mistaken for spotting)

Your gynecologist can perform a pelvic exam, Pap smear, and a visual exam called a colposcopy to diagnose cancer. They might also take a tissue sample to look at under a microscope.

The treatment for reproductive cancers depends on the type and stage but can include chemotherapy, radiation, surgery, and immunotherapy.

Summary

Noticing blood during or after sex can be alarming, especially if you’re not menstruating. Some causes include a sexually transmitted infection, benign polyps, cervical ectropion, atrophic vaginitis, endometriosis, trauma, and cancer.

If you’re experiencing bleeding when you’re having sex or after sex, it’s important to tell your provider. They can diagnose the cause and recommend the right treatment.

Frequently Asked Questions

Does light spotting after sex mean I’m pregnant?

Light spotting can be a sign of pregnancy but there are also other causes. The only way to find out for sure is to talk to your provider.

Can a yeast infection cause bleeding?

A yeast infection can cause bleeding but usually only if it has progressed to vaginitis. A yeast infection more often causes itching, redness, pain while urinating or during sex, and an odorless, white discharge.

How long does postcoital bleeding last?

How long postcoital bleeding lasts depends on the cause—specifically, whether the bleeding is vaginal or cervical. For example, direct trauma to the vaginal walls can cause heavy and bright-red bleeding that lasts for a short time. Cervicitis can cause bleeding after sex that varies in how long it lasts.

Why does sex hurt?

There are many possible reasons why sex may hurt. For example, STIs like chlamydia and herpes can cause painful sex for anyone. In people with a vagina, pain during or after sex can be caused by vaginal dryness related to menopause, low sexual arousal, vaginismus, irritation caused by latex or spermicides, and endometriosis. In people with a penis, pain during sex can be caused by a tight foreskin, prostate gland inflammation, or small tears in the foreskin.

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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By Tracee Cornforth
Tracee Cornforth is a freelance writer who covers menstruation, menstrual disorders, and other women’s health issues.