I bleed every time I have sex, but it s not painful. Should I be concerned

Bleeding After Sex

You’ve just finished having sex with your partner, when you look down and see blood on the sheets. You don’t have your period and aren’t supposed to get it anytime soon, so what gives?

While vaginal bleeding after sex can be scary, it’s also fairly common. It affects up to 9% of menstruating women. There’s probably no cause for concern. But it can also result from an infection. In rare cases, it’s a sign of cervical cancer.

Causes of Bleeding After Sex

The most common causes for vaginal bleeding after sex both start in the cervix, which is the narrow, tube-like end of your uterus that opens into the vagina.

One of those causes is cervical inflammation, or cervicitis. It can be ongoing and totally harmless, or it can happen because of a sexually transmitted infection that you need to get treated, like chlamydia or gonorrhea. Both types of cervical inflammation can cause bleeding after sex.

A second common reason for bleeding after sex is cervical polyps. These growths are usually small — about 1 to 2 centimeters. They often appear on the opening of your cervix. Most aren’t cancerous. Your doctor can remove them during an appointment.

Other causes of vaginal bleeding after sex include:

Americans see their primary care doctors less often than they did a decade ago. Adults under 65 made nearly 25% fewer visits to primary care providers in 2016 than they did in 2018, according to National Public Radio. In the same time period, the number of adults who went at least a year without visiting a primary care provider increased from 38% to 46%.

• Friction during sex or not enough lubrication
• Normal uterine bleeding if you’re just beginning your period or if it’s just ended
• A cervical or vaginal infection
• Genital sores caused by herpes or another condition
• A precancerous cervical spot
• Cervical ectropion (when the inner lining of the cervix pokes through the cervical opening and grows on the vaginal side of the cervix)
• Pelvic organ prolapse (when pelvic organs, like the bladder or uterus, protrude or fall just beyond the vaginal walls)
• Cancer of the cervix, vagina, or uterus

Dryness caused by these things can also lead to vaginal bleeding:

• Breastfeeding
• Childbirth
• Some cold, allergy, and anti-estrogen medications
• Cancer therapy and its effect on your ovaries
• Douching
• Sjögren’s syndrome
• Menopause

While many of these causes don’t need treatment and are harmless, sometimes vaginal bleeding after sex can be a sign of a more serious problem.

Risk Factors for Bleeding After Sex

You may have a higher chance of bleeding after sex if you:

• Have cancer of the cervix, vagina, or uterus
• Are going through menopause or perimenopause (the transition to menopause)
• Had a baby not long ago or are breastfeeding
• Aren’t fully aroused before vaginal penetration
• Use douche products
• Have an infected cervix
• Have a sexually transmitted disease or sexually transmitted infection

Is Bleeding After Sex Serious?

If you have some minor bleeding every once in a while, chances are everything is fine. But the only way to know for sure is to see your doctor for a physical exam.

If the bleeding happens right before you get your period or within a few days after it ends and it doesn’t happen again, you can hold off on making that appointment. You can also probably hold off if you recently had a pelvic exam and Pap smear and got a clean bill of health. In all other cases — or if you’re just worried — it’s best to get checked out to rule out infection or anything more serious.

Bleeding After Sex and Menopause

If you’re postmenopausal, any bleeding after sex isn’t normal. See your doctor to rule out cervical cancer, endometrial cancer, and other issues.

Bleeding After Sex and Pregnancy

Vaginal bleeding after sex can be scary if you’re pregnant, but it probably isn’t a cause for concern. Your cervix may bleed more easily during pregnancy because extra blood vessels are developing in the area.

Bleeding After Sex Diagnosis

Your doctor’s first step will probably be to ask you some questions to see if there’s an obvious cause for the bleeding, like breakthrough bleeding after you just start to take a birth control pill.

They’ll also want to know if you’re having pain during sex, which can be a sign of dryness or infection, depending on when it happens.

The doctor will give you a pelvic exam and look for any source of the bleeding, like vaginal tears or lesions, signs of pelvic organ prolapse, cervical polyps, or inflammation. If you have polyps, they might be able to remove them in the office and send them to a lab for testing. Or you might need a later appointment to have them surgically removed. You could also get a:

• Pregnancy test
• Cervix exam with a tool called a speculum
• Colposcopy
• Transvaginal ultrasound
• Pap test
• Test for a sexually transmitted disease or sexually transmitted infection

During a Pap test, the doctor can swab your cervix to test for any sign of abnormal, precancerous growths or cancer cells. But they will also use the test to check for any sexually transmitted infections like chlamydia and gonorrhea, which can cause bleeding after sex and are treated with antibiotics.

Abnormal Results

If the Pap test reveals any problems with your cervix at the time of your exam, you’ll probably get a colposcopy. It starts out like a Pap test but takes a bit longer. The doctor will use a special magnifying device called a colposcope to get a closer look at the cervix. If they see anything suspicious, they can take a small sample of tissue for testing.

If bleeding after sex is an ongoing thing, the doctor may recommend a colposcopy even if your Pap test results are normal, to get a better look at your cervix.

If you’re postmenopausal, the doctor might do a transvaginal ultrasound to get a closer look at your pelvic organs. They might also do an endometrial biopsy to check for abnormal cells in the endometrial tissue that lines your uterus.

Treatment for Bleeding After Sex

Since there’s no one cause of bleeding after sex, there’s no single treatment. Some options include:

• Vaginal lubricants and moisturizers
• Medication for sexually transmitted infections
• Estrogen therapy
• Cervical cancer treatment (surgery, chemotherapy, or radiation)
• Polyp removal

Can Bleeding After Sex Stop on Its Own?

It might. A recent study found that just over half of women who had bleeding after sex reported that it cleared up on its own within 2 years.

Preventing Bleeding After Sex

You can make some lifestyle changes to lower your risk of bleeding after sex:

• Use a lubricant before and during sex
• Wait a bit longer after your period ends to start having sex again.
• Have your doctor remove any cervical polyps or treat cervical infections.
• Have more foreplay before penetration
• Try less aggressive sex

Show Sources

Mayo Clinic: “Vaginal bleeding after sex: Definition,” “Vaginal bleeding after sex: Causes,” “Chlamydia: Symptoms,” “Gonorrhea: Symptoms and causes,” “Vaginal bleeding after sex: When to see a doctor,” “Chlamydia: Treatments and drugs,” “Colposcopy: What you can expect,” “Colposcopy: Definition.”

Obstetrics and Gynecology International: “Postcoital Bleeding: A Review on Etiology, Diagnosis, and Management,” “Vaginal dryness after menopause: How to treat it.”

Harvard Medical School: “Cervical Polyps.”

ACOG: The American Congress of Obstetricians and Gynecologists: “FAQs: Perimenopausal Bleeding and Bleeding After Menopause,” “FAQs: Cervical Cancer,” “FAQs: Bleeding During Pregnancy.”

American Cancer Society: “Cervical Cancer,” “Cervical Cancer: Signs and Symptoms of Cervical Cancer.”

CDC Publication: “Cervical Cancer.”

National Health Service (U.K.): “What causes a woman to bleed after sex?”

Cleveland Clinic: “Do You Bleed After Sex? When to See a Doctor.”

HealthyWomen: “Bleeding After Sex: Should You Be Concerned?”

RagiologyInfo.org: “Abnormal Vaginal Bleeding.”

I bleed every time I have sex, but it’s not painful. Should I be concerned?

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• Bleeding often from penetrative sex shouldn’t be taken lightly.
• The sooner you can see your doctor, the better because “everything that causes this isn’t normal, but most things that cause this are treatable,” New Jersey-based gynecologist Dr. Donnica Moore said.
• Pregnancy, STDs, cervical polyps, cervical cancer, and vaginal cuts are all potential causes of vaginal bleeding after sex.
• Read more Doing It Right here.
• Visit Insider’s homepage for more.

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I’m in my early 20s and I’ve only ever been with one person sexually. But practically every time we have sex, I bleed.

It isn’t painful ever, and I usually enjoy myself. But I often find the bleeding to be quite embarrassing and also concerning.

I’ve heard about people bleeding while losing their virginity or trying things without the proper lubrication, but my issue is neither of these. Is it normal to bleed during or after vaginal sex?

– Pennsylvania

Oh no! I’m glad you haven’t been in pain, but bleeding that often from sex shouldn’t be ignored.

I don’t want you to panic because this isn’t an emergency-room situation, but you should call your gynecologist right away and inform them about what you’ve been dealing with.

The sooner you can see your doctor, the better because “everything that causes this isn’t normal, but most things that cause this are treatable,” Dr. Donnica Moore, a New Jersey-based gynecologist and host of the podcast In the Ladies’ Room with Dr. Donnica, told me.

According to Moore, for a woman in her 20s like you, the most common cause of vaginal bleeding during sex is something called cervical inflammation in the area where your uterus connects to your vagina. The condition can happen when your vagina has an infection, either a bacterial one or sexually transmitted infection like chlamydia, gonorrhea, or herpes. The condition can cause pain-free bleeding during sex and in between period cycles, according to Harvard Health.

Another reason you could be bleeding is if there are polyps, tiny and benign reddish-pink growths, in your cervix. Cervical polyps occur in between 2% and 5% of women and sometimes friction from vaginal sex can cause them to bleed. According to Moore, these little guys can be “easily taken care of” with a minor procedure where a doctor removes them from your cervix to prevent future bleeding.

The cause of your bleeding could be as simple as a cut in your vagina too, which, according to Moore, can happen during finger play or while you’re inserting a tampon. If you have a cut inside of you, vaginal sex could open it back up and lead to the blood you see post-coitus. To fix this, Moore recommended abstaining from penetration with tampons, fingers, penises, or anything else you personally fancy until it’s fully healed.

Another thing: Is there a possibility you could be pregnant? Moore said vaginal bleeding during early pregnancy can often occur due to the implantation phase when a fertilized egg first attaches to the uterine lining. According to the American Pregnancy Association, one-third of pregnant women will have implantation bleeding and it happens typically six to 12 days after conception.

One final cause of vaginal bleeding, though rare for women your age, is cervical cancer. Please don’t worry! Most women who are diagnosed with this type of cancer are between the ages of 35 and 44. Still, it’s important to check in with your doctor and keep up with annual pap smears to ensure you don’t have the disease or catch it in its early phases so you can get proper treatment.

I probably just threw way more than you bargained for your way. Unfortunately, you can’t determine what’s going on with your vagina until a doctor tests you, so pick up the phone as soon as you can. You did the right thing in being concerned about your own sexual health and with the right help, you’ll have the answer you’re looking for very soon.

As Insider’s resident sex and relationships reporter, Julia Naftulin is here to answer all of your questions about dating, love, and doing it — no question is too weird or taboo. Julia regularly consults a panel of health experts including relationship therapists, gynecologists, and urologists to get science-backed answers to your burning questions, with a personal twist.

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