Is bleeding after sex normal?

The sight of blood during any intimate moment can be alarming and confusing, especially when it’s definitely not your time of the month. Bleeding during and after comes with its own medical term - ‘postcoital bleeding’.

According to a study published in Obstetrics and Gynaecology International up to nine percent of all sexually active women experience postcoital bleeding at some point in their lives. However, it is important that any post coital bleeding is checked out by your doctor as it could be related to any of the following:

Infections

An infection, such as pelvic inflammatory disease (PID) can involve symptoms of bleeding between periods and after sex. PID generally affects sexually active people and is most common in those aged 20-24 and can be treated with antibiotics.

Yeast and bacterial infections can also lead to inflammation of the delicate tissues that line the vagina and cervix which makes them more prone to micro-tears and bleeding during sex. Depending on the infection, some treatments may be available over the counter, for example, for vaginal thrush, but if these aren’t effective or you aren’t sure please see your doctor.

Sexually transmitted infections (STIs), such as Chlamydia and Gonorrhoea don’t always have symptoms, particularly among women, but post-sex bleeding can flag these conditions. The best thing to do if you are sexually active, whether or not you have post coital bleeding, is to regularly have a sexual health check and STI tests.

To avoid infections and prevent the spread of STIs take a look at our sexual wellness range which includes intimate care, condoms and sex toy hygiene.

Vaginal dryness

Millions of us experience it, but we’re not always necessarily the most eager to discuss it. Yep, we’re talking vaginal dryness. Vaginal dryness during sex can be frustrating, to say the least, but it can also be one of the causes of bleeding after or during sex. If the vaginal tissues are thin and not lubricated enough, the friction from intercourse can be irritating to the tissue and cervix causing vaginal bleeding or spotting.

Vaginal dryness effects people in many different ways but we’d highly recommend using lubricant to increase comfort and decrease friction during penetrative sex. You can also employ more (gentle) foreplay and go slowly at first to reduce the risk of tearing. Read more about vaginal dryness in our What Causes Vaginal Dryness Guide.

Vaginal damage (Rough sex)

Even if you don’t experience vaginal dryness, friction can still occur during sex, particularly rough sex, which can lead to damage to the vagina and bleeding. Although some spotting or bleeding is normal due to the delicate tissue around the vagina and cervix, especially if you’re having sex for the first time in a while, it’s still important that you feel comfortable during sex and if you feel things are starting to become rougher or more vigorous than you’d like, make sure you ask to stop and communicate this with your sexual partner. Deeper positions, rough sex and intense use of BDSM & bondage must be consensual, and you don’t have to wait until you see or feel blood to say something.

Pregnancy

Since your cervix becomes more sensitive during pregnancy, a small amount of bleeding can occur if the cervix is bruised during deep penetration or a physical exam. Spotting or light bleeding in the first trimester is quite common. In fact, the American College of Obstetricians and Gynaecologists (ACOG) says about 15 to 25 percent of women will experience bleeding during the first 12 weeks of pregnancy. However, bleeding in pregnancy, whether or not it is related to sex, should be assessed by your medical team.

Following a pregnancy, tears caused by childbirth can also lead to vaginal bleeding. There may be scar tissue in or around your vagina that will soften over time. It might be a good idea to take things slow in the beginning. Take a look at our article on retaining your sexuality during and after birth. However, be sure to have any bleeding checked out.

Cervical ectropion

A cervical ectropion, also sometimes called cervical erosion, is a condition which is more common if you are pregnant or on the combined oral contraceptive pill. Here there is an inflamed area on the surface of the cervix which is more prone to bleeding during or after sex.

Polyps

A polyp is a non-cancerous (benign) growth, if there are polyps in the cervix or womb, they can also cause post coital bleeding.

Cervical or vaginal cancer

More rarely, post coital bleeding can be due to cervical or vaginal cancer. Please note it’s important that all women aged 25 to 64 get regular cervical screening test to help prevent cervical cancer.

Bleeding after sex has lots of possible causes, but please remember it is always important to speak to your doctor and to get it checked out!