Bled from rough sex — Should I see a doctor?

Dear Rammed,

From your question, it’s not clear whether you’re experiencing vaginal or anal bleeding. While it may be common to bleed after your first time having vaginal sex, subsequent instances may be due to a number of causes. No matter the source of your bleeding, it's best to see a health care provider as they can help diagnose the specific cause and recommend an appropriate treatment and prevention strategies. Beyond getting this checked out, a dose of communication may also be in order.

Anal bleeding often involves tearing in the lining of the rectum. If you’re experiencing anal bleeding, it’s critical to abstain from sex as it can increase the risk for sexually transmitted infections (STIs) and further damage. Vaginal bleeding after sex, on the other hand, may be due to concerns such as:

• Vaginal dryness
• Friction during sex
• Inadequate lubrication during sex or foreplay
• Menstruation
• Pelvic inflammatory disease (PID)
• Genital sores from sexually transmitted infections (STIs)
• Cervical polyps (benign, noncancerous growths on the cervix)
• Cervicitis (inflammation of the cervix)
• Cervical ectropion (the lining of the cervix protrudes out and grows on the outside of the cervix)
• Cervical or vaginal cancer

List adapted from Mayo Clinic. 

This list isn't comprehensive so it’s best to have your health care provider take a look and recommend a treatment plan.

Rammed, it may also be a good idea to reflect on whether you enjoy engaging in this type of sexual activity. Was this something you and your partner both agreed upon? If so, consider steps for reducing the chance of this happening in the future — for instance, you may ask your partner to go slower, communicate clearly if you're experiencing pain, and use lubrication to minimize any uncomfortable friction during sex. It’s also worth noting that if you ever feel discomfort or pain during sex, you have the right to stop your partner. You can say something like, "No, this is too rough;" or, "Stop, you're hurting me!" If this isn’t something you agreed to, it will be good to have a conversation with your partner about the type of activities you’re comfortable with to ensure experiences that are pleasurable to you both. You can say something like, "The last time we had sex, you were a little too rough. It caused bleeding and I had to get it checked out. I don't want that to happen again, so I will let you know when to stop or ease up, okay?" It could also be good to ask your partner if there are other ways to have sex that are pleasurable to you both that don't result in bleeding or are less rough. 

Talking with a health care provider to address and treat this bleeding, talking with your partner, and taking steps to prevent this in the future are good ways to get you back to pleasurable action.