There are bodily fluids we expect to see during or right after sex, depending on who you are: discharge, semen, vaginal fluids, maybe even a little bit of saliva. But most of us aren’t expecting to see blood, and when it does happen, it can be a bit alarming.
Bleeding after sex isn’t ‘normal’ per se, but according to a study published in Obstetrics and Gynecology International, nine percent of sexually active [cis] women will experience some postcoital bleeding (the proper medical term for this) at some point during their lives.
So, what causes bleeding after sex? And should you be concerned? We spoke to experts Sarah Welsh, gynaecologist and founder of condom company Hanx and Dr. Zaakira Mahomed, GP at contraception comparison and advice platform The Lowdown. They break down some of the common reasons for bleeding after sex, and how to know when blood means it’s time for a trip to your doctor.
Bleeding after sex can happen for a variety of reasons, ranging from ‘not to worry’ to ‘please see a doctor.’ Most of the time, bleeding after sex isn’t a cause for alarm. Mahomed explains that bleeding after sex can be caused by a benign polyp on the cervix, or something called a cervical ectropion, neither of which are concerning. Sometimes, though, bleeding after sex can point to underlying health conditions.
Breaking a sex drought
If you’ve had partnered sex for the first time in a while, or this is the first time you’re having partnered sex (especially involving a penis), this could be the reason behind the bleeding. If you haven’t had sex for a while — and what constitutes a ‘while’ is completely individual to you — it’s pretty commonplace for the vagina to bleed a little after sex.
And no, this isn’t your « virginity » growing back, no matter what anyone tells you. The whole idea of « virginity » isn’t real and you can skip partnered sex for as long as you like. Sex droughts don’t have any kind of effect on your physical health. All this means is your vagina’s a little sensitive after a lack of use. This can result in some tiny microtears in all that delicate tissue around the vagina and that’s where the blood comes in. Don’t worry, it will be on its way again soon.
It’s also fairly common to see a bit of blood after having penetrative sex for the first time. This is because the hymen — the thin piece of skin that partially covers the entrance to the vagina — can stretch, tear, or break during first-time penetrative sex.
Bleeding after rough sex
Bleeding after sex can also be due to the type of sex itself, Mahomed tells Mashable. « This is particularly if it is on the vigorous side or there is not enough lubrication, causing friction, » he says.
Welsh adds that, in some cases, particularly rough sex, or use of certain sex toys and accessories, can cause vaginal tears or trauma to the vagina and tissue around it, which brings on bleeding.
Mahomed notes that increased friction during sex and lack of lubrication can add to these problems.
In this situation, it may be that you need to have a chat with your partner about slowing things down, going a bit easier on you until the bleeding has subsided, or making sure you’re adequately aroused and lubricated to handle the level of rough sex you’re having.
Welsh recommends a good lube to solve this problem, saying « excessive penetrative sex can also cause bleeding, so it’s always important to remember to use lubricant. A water-based, pH balanced option is your safest bet to ensure no irritation or imbalance in the vagina. »
Bacterial or yeast infections
According to the NHS, bleeding after sex can be a sign of a health condition like bacterial vaginosis (BV) or a yeast infection (also known as thrush).
Yeast and bacterial infections can naturally lead to inflammation of the delicate tissues that surround the vagina and cervix, leaving your genitals a little more delicate and sensitive during sex. So, when penetrative penis-in-vagina sex happens (which is famously full of friction), microtears and bleeding can happen.
Bacterial infections— like BV — will need an antibiotic to clear out, and ideally as soon as possible. Symptoms of BV are usually pretty easy to spot, since it usually involves excessive thick, white discharge, and a foul fish-like smell. If you’ve had any of these symptoms along with bleeding after sex, speak to your doctor about treatment.
Is your contraception causing bleeding?
Mahomed notes that certain types of contraception can cause bleeding or spotting at various times of the month, which may coincide with sex and be mistaken for postcoital bleeding. « At The Lowdown, many of our users have reported spotting on the pill, particularly for progestogen-only pills such as Cerazette and Noriday. Often this bleeding settles within three months of use, » she explains. If you think this might be behind your post-sex bleeds, especially if you’ve started a new contraception recently, it’s worth speaking to a medical professional for advice.
Are you pregnant?
During pregnancy, your body inevitably experiences a lot of big changes. And a lot of those go down in the cervix. The NHS note on their website that a lot of pregnant people experience pinkish or brown discharge during the first trimester of pregnancy, along with some potential blood spotting after sex.
This can happen due to the developing embryo implanting itself in the wall of your womb and bleeding may occur when your period would have been due.
This tends to be nothing serious, but if you’re pregnant and bleeding after sex becomes heavy, clotted, or you experience other symptoms like lightheadedness, breathlessness or chest pain, you should seek urgent medical care.
Are post sex bleeds just a surprise period?
It’s a common misconception that blood noticed after sex is ‘a bit of leftover period‘, with many women presuming that. Welsh explains that while It is possible that during sex, the movement of your uterus can cause a little bit of blood that was left in your uterus to flow out, it’s unlikely to be the reason for bleeding after sex.
« Some women experience irregular cycles and menstrual bleeding, due to hormonal fluctuations, which can muddy the waters if this bleeding happens after sex after your period (but would have happened anyway). » She adds: « The more likely cause for bleeding after sex, though, is one of the above reasons such as infection, vaginal dryness or a cervical lesion. »
Go for your cervical smear test
It’s also, as always, important to stay on top of your smear tests (also known as cervical screenings and pap smears).
There’s a very minuscule chance that bleeding after sex would allude to cervical cell changes or cervical cancer, but it’s nice to rule the possibility out. Going for your smears and ensuring they’re up to date prevents cervical cancer cases, and is a nice check-in with your cervix to make sure everything’s in working order.
What should I do if I’m worried about bleeding after sex?
While most of the time bleeding after sex is nothing to worry about, it’s understandable to feel concerned and there’s nothing wrong with intervening to double-check it’s not anything serious. Welsh explains that, in this case, you should speak to a medical professional such as your doctor, gynaecologist, or a local sexual health clinic.
« They are likely to examine you and have a look at your cervix, as there could be a common benign condition here that is the cause of the bleeding, such as an ectropion (also known as a cervical erosion), » she explains. But by examining you, a health professional may also be able to see if you have a vaginal infection such as thrush or anything else that looks like it could be causing a bleed.
« They will also take any vaginal swab test and in some cases blood tests too. This will be sent to the lab for testing for infections, such as chlamydia, » she adds.
So, don’t panic if you see a bit of blood after sex. It’s often nothing, but worth ruling out STIs and pregnancy with tests. And if you are worried, you have every right to speak to a medical professional, even if it’s just for your own peace of mind. No one knows your body like you do, and feeling secure in your health is a key part of sex, just as important as the actual act.
