Dear Alice,

I had not had intercourse for over a year, and then recently I had intercourse and experienced vaginal bleeding. What could be the cause of this?

Dear Reader,

Rest assured that many women experience vaginal bleeding associated with penetration or sexual intercourse. Most vaginal bleeding is considered normal and does not require medical treatment, especially if you’re premenopausal and have normal results on routine pap smears and pelvic exams. Not having sex in over a year could have very well played a part in the bleeding. Have you had intercourse since? If so, did you experience any bleeding? Here are some common causes of post-intercourse vaginal bleeding:

  • Spotting throughout the menstrual cycle not associated with intercourse, especially when using hormonal contraceptives.
  • Friction caused by the penis or an object rubbing on the lower end of the uterus, also known as the cervix.
  • Inadequate lubrication or foreplay before penetration.
  • Normal cervical changes throughout sexual development and menopause.
  • Sexually transmitted infections (STIs), such as chlamydia, gonorrhea, or HPV.
  • Pregnancy.
  • Irritation of the outer or inner lips that can be mistaken for bleeding from the vagina.
  • Vaginal dryness.
  • Urinary tract infections (UTIs), which can be accompanied by blood in the urine.
  • Cervical polyps, if vaginal bleeding is bright red in color.
  • Irritated and/or inflamed vaginal tissue due to excessive or vigorous penetration or vaginal trauma.

Bleeding is sometimes indicative of more serious conditions, especially for postmenopausal women. If you’re concerned about vaginal bleeding, an appointment with a women's health care provider or gynecologist is a good next step. Your doctor will ask you for details about the bleeding, including questions about the color and flow of blood. Next, your doctor will examine you to determine whether the bleeding is coming from your vagina, cervix, vaginal walls, inner lips, and/or urethra. This and other information helps your provider determine or rule out other possible causes, and get appropriate diagnosis and treatment for you.

If you’re a Columbia student and you want to see a doctor, you can schedule an appointment with Medical Services on the Morningside campus through Open Communicator. If you’re a student on the Medical Center campus, you can make an appointment with Student Health.

Take care,


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