Blood loss after or during sex is usually mild. However, regular bleeding should alert you and be the subject of a gynecological consultation. What are the causes of bleeding after sex? When to worry?
Bleeding after intercourse can be surprising. The post-coital bleeding are, in most cases mild and not serious. Losing a little blood on the rare occasions is not necessarily worrying. On the other hand, if the bleeding appears regularly and is accompanied by pain or burning, an appointment with the gynecologist is necessary, because this could be a sign of more serious causes which must be quickly taken care of. Obstetrician-gynecologist, tells us about the different factors that can explain this bleeding.
A sexually transmitted infection (STI)
Sexually transmitted infections can cause many unpleasant symptoms, and bleeding after sex is certainly one of them – especially if the infection results in inflammation of the cervix, called cervicitis , says Dr. Bagot. STIs like chlamydia, gonorrhea, and trichomoniasis can cause inflammation of the cervix . “The gynecologist will take bacteriological samples to verify this hypothesis”, she adds. You may have contracted an STI without showing any noticeable symptoms, which is why it is important to see a doctor when you have a symptom such as abnormal bleeding. You will be prescribed appropriate treatment to overcome the infection.
Some polyps cause bleeding after sex. Most of the time, they are benign (non-cancerous). Their size can vary from a few millimeters to a few centimeters. During intercourse, they can be touched and rubbed, causing bleeding. It should be noted that polyps are more common in older women, usually 40 years and older. A gynecological examination will establish a diagnosis. Polyps can be removed if they cause bothersome symptoms.
Ectropion, a common cause
“An ectropion at the level of the neck is sometimes involved”. “The tissue that lines the inside of the cervix will rather go outwards, so it will be in contact with vaginal secretions. This tissue is not covered with skin mucosa, which means that small vessels can bleed, ” says the specialist. Ectropion of the uterus is a benign pathology which resolves spontaneously in the majority of cases. If it is too troublesome, then treatment is prescribed.
Cracks in the vestibule
“Cracks in the vestibule can cause bleeding, but they are usually accompanied by pain and burning,” says the gynecologist. A gynecological examination will observe if cracks are present.
Cervical cancer, the most worrying hypothesis
The most serious cause of bleeding after sex is cancer of the cervix. ” Postcoital bleeding can reveal cancer of the cervix, even if it is very rare “. If you have continuous or persistent abnormal bleeding, you should see your gynecologist. “He’ll take a close look at your cervix and make sure you’re up to date on your Pap smears and HPV tests,” says the expert. Regular gynecological follow-up makes it possible to identify cancer at the first symptoms and to treat it as effectively as possible.
If your vagina is not sufficiently lubricated, penetration can cause painful friction, which tears vaginal tissue and causes bleeding. Your doctor may suggest different options that are effective for vaginal dryness that include vaginal lubricants, moisturizers, and estrogen, depending on the cause of the dryness. In addition, this drought could be linked to an underlying problem, such as inadequate contraception.
Bleeding after intercourse: when to consult?
Bleeding after intercourse can be more or less profuse and has several origins. “If we did our screening smear on time and we just have a little bleeding from time to time, there is, a priori, nothing to worry about,” says Dr. Bagot. Repeated bleeding should be reported to your doctor, general practitioner or gynecologist, to find the cause and seek treatment.
Reminder : The first smear is recommended at the age of 25, followed by a second one year later. If no abnormality is found after these two normal smears carried out one year apart, the recommended rate is one smear every three years. After 30 years, the sample is used as the basis for the HPV test (search for the presence of high-risk papillomavirus DNA in cells), now recommended as first-line treatment, and no longer for the cytological examination. The interval between two HPV tests is 5 years.
The management obviously depends on the cause.
- If the post-sex bleeding is due to an infection, the gynecologist will prescribe an appropriate treatment.
- In the event of vaginal dryness , a diagnosis is necessary to identify the cause (menopause, hormonal imbalance, etc.). A treatment, using eggs, creams, and lubricant during intercourse, may then be prescribed.
- The polyps and ectropions can be removed by a doctor if they cause bothersome symptoms.
Image source: Getty Images