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What Causes Bleeding After Sex

Dr. Lisa Lawless

Dr. Lisa Lawless, CEO of Holistic Wisdom
Clinical Psychotherapist: Relationship & Sexual Health Expert

lubricants for bleeding after sex, sex toy, red heart candy

Postcoital Bleeding

Many people with vaginas experience bleeding after vaginal penetration (postcoital bleeding), and occasional light bleeding is not typically a cause for concern. It can also happen when using penetrative sex toys such as a dildo or G-spot vibrator. Bleeding can come from the urethra, labia, uterus, and cervix. As much as 63 percent of postmenopausal people experience vaginal dryness, thinning of the vaginal tissue, and light bleeding after penetrative sex.

Vaginal Tears

Rough sexual activity may cause tearing. Most small tears will heal without any medical assistance, but larger ones may require medical treatment. Avoid sexual penetration until the tear has healed. If the vaginal tear continues to bleed for more than a couple of minutes or if it is heavy bleeding, seek medical care as soon as possible.

If a vaginal tear causes the bleeding, it should heal completely in two weeks. If you require stitches, those will dissolve in about six weeks. You will want to ensure that you do not make germs easier to enter your body and make you more vulnerable to infection. General suggestions for preventing infection are below; however, always consult with your physician with any concerns or questions.

  • Wash your hands for at least 30 seconds with soap and water before touching the wound.

  • If toward the vaginal opening, wash the wound with warm water and a body-safe, unscented soap or cleanser. You may wish to use a peri bottle to rinse the wound with purified water. A peri bottle is a bottle that is used for rinsing your perineum after giving birth and may gently warm and relax the vulva.

  • Ensure it is patted dry before getting dressed, and keep it dry throughout the day. You may wish to use a panty liner to absorb traces of blood and wick away moisture.

  • Avoid soaking the wound in water, such as in a bath or hot tub.

  • Discomfort may be relieved by taking over-the-counter pain medications.

  • If the wound is external, applying an ice pack to reduce swelling and inflammation may help discomfort.

  • Applying witch hazel on a sanitary napkin has been known to reduce discomfort for wounds that would touch it.

  • Sitting on a soft pillow may provide some added relief.

Other Common Causes

Menopause

As menopause kicks in, lower estrogen levels can cause vaginal dryness, less elasticity, and blood flow to the vaginal tissues. Menopause can cause vaginal atrophy, known as genitourinary syndrome of menopause (GSM). This can cause vaginal dryness, burning, itching, tightening, shortening, and bleeding. It can also cause an increase in urinary tract infections (UTIs) and incontinence.

Please see our helpful guides: Vaginal Dryness Remedies and Perimenopause & Menopause.


Vaginal Yeast Infection

A vaginal yeast infection is caused by the fungus candida, which can cause white, thick discharge, itchiness, and irritation of the vagina and the vulva. It is typically treated with an antifungal cream. See our Natural Yeast Infections Remedies Guide for more information.


Bacterial Vaginosis

Bacterial vaginosis (BV) is a vaginal infection caused by bacteria and causes a fishy-smelling vaginal discharge, irritation, and is most common in those who have not gone through menopause yet.


Cervical Polyps

Cervical polyps or precancerous changes to cervical cells. Cervical polyps are growths (singular masses or clusters) on the lower uterus, usually noncancerous (benign). They are considered precancerous because, on a rare occasion, cervical cancer develops from them. However, most cervical cancer is caused by the STD human papillomavirus (HPV), known as genital warts.

For more information on cancer, please see our Sex With Cancer Guide.


Fibroids

Fibroids are found in 70 to 80 percent of people with vaginas and develop in or on the uterus. They can become quite large (up to the size of a watermelon) and are fueled by estrogen. Once menopause begins, they will stop growing and may shrink. They can cause abdominal pain and heavy periods. They are typically noncancerous (benign).


STIs & STDs

An STD, such as Gonorrhea or Chlamydia. For more information on STDs, please see our helpful guide STDs & Prevention.


Pelvic Inflammatory Disease

Pelvic inflammatory disease (PID) located in the uterus, fallopian tubes, and ovaries is an infection that can cause abscesses and scar tissue to damage the reproductive tract.


Cervicitis

Cervicitis is an irritation or infection of the cervix typically caused by bacterial and viral infections related to sexually transmitted infections (STIs), such as chlamydia, gonorrhea, trichomoniasis, and genital herpes.


Vaginitis

Vaginitis is inflammation that causes discharge, itching, and pain. It is often caused by a fluctuation of bacteria or reduced estrogen.

Increased Bleeding Risks

There are a few things that can make one more prone to bleeding after sex:

  • You douche often
  • You are perimenopausal, menopausal, or postmenopausal
  • You are not fully aroused or lubricated before penetration
  • You recently gave vaginal birth
  • You have a vaginal health condition

Seeking Care

You should communicate with your healthcare provider when you have a health concern, but you should especially report any of the following symptoms:

  • Bleeding after menopause
  • Heavy bleeding
  • Vaginal pain, itching, burning, stinging
  • Abdominal or lower back pain
  • Nausea or vomiting
  • Unusual vaginal discharge

Once your healthcare provider assesses the cause of your bleeding, they will determine the proper treatment for you, including things such as lubricants, estrogen therapy, or antibiotics.

In Closing

Bleeding from vaginal penetration can feel concerning, but it is quite common. The most important thing you can do is be observant of your symptoms, nurture yourself and seek medical help when you feel you need it to ensure that you are taking care of yourself. For helpful insights into what the best lubricant is for you to use, please see our Personal Lubricant Guide as well as Painful Vaginal Sex Guide.

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