Bleeding after sex

Bleeding after intercourse is a common symptom and there are several reasons why it can happen. If you have experienced bleeding with sex for more than three months then you should see a specialist. Bleeding can range from light spotting to a heavy 'period-like' bleed.

• pelvic infection, particularly if bleeding is associated with pain and discharge. Getting an STI screen is always a good idea if you have bleeding with sex.
• an ectropion is a normal finding on the cervix. It is a collection of glandular cells originating from the within cervical canal that have migrated onto the outside of the cervix. These glandular cells are delicate and bleed easily with any contact and so women will invariably complain of bleeding with sex due to the penis touching the cells. An ectropion does not necessarily need any treatment but if symptoms are bothersome, the cells can be removed or destroyed using a heat treatment. This is a minor procedure done in clinic using local anaesthesia.
• in women that are post-menopausal, the tissues of the vagina become dry and atrophic due to lack of oestrogen. This can cause the vagina to bleed with friction from sex. Relaxing oestrogen in the vagina or using a vaginal moisturiser can be very effective.
• benign polyps (fleshy growths) are a common finding on the cervix that can bleed with contact. Polyps are usually easily removed in the clinic.
• some contraceptives can cause bleeding with intercourse.

Bleeding after sex can be a sign of cervical cancer and so it should always be investigated. That said, cervical cancer is rare in the UK (9 cases per 100,000 women) and post-coital bleeding is a common symptom. Cervical screening is an effective way of preventing cervical cancer and if you have regular smear tests your risk is extremely low.

If you suffer from bleeding after sex, see a specialist so that a serious cause (such as cervical cancer) can be excluded. A colposcopy examination of the cervix will be performed. This involves looking at the cervix in detail using a microscope.
Treatment of bleeding with sex is on an individual basis and depends on the cause of the bleeding and how bothersome the symptoms are.