Vaginal bleeding after sex

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 vaginal bleeding following penetrative vaginal sex is fairly common. In most cases, it doesn’t require medical treatment, particularly when it occurs infrequently in individuals who are pre-menopausal and have normal Pap smear and pelvic exam results. In your situation, it could be that not having had sex in over a year played a part in the bleeding. Have you had penetrative sex since? If so, did you experience any bleeding? If you don’t notice a correlation between your vaginal bleeding and sex, there could be a number of other potential causes, most of which are treatable.

Some other possible causes of vaginal bleeding include:

  • Spotting throughout the menstrual cycle, especially when using hormonal contraceptives
  • Friction caused by rubbing on the cervix during sex or other penetration
  • Vaginal dryness related to inadequate foreplay or lubrication before penetration  
  • Irritated or inflamed vaginal tissue due to excessive or vigorous penetration or vaginal trauma
  • Sores that may appear on the genitals due to sexually transmitted infections (STIs)
  • Vaginitis, which can be caused by conditions such as bacterial vaginosis or a yeast infection
  • Benign growths such as cervical polyps or lesions
  • Inflammation of the cervix
  • Cervical ectropion, which causes the lining of the cervix to protrude through the cervical opening
  • Uterine prolapse which causes the uterus to move out of its normal position and expose the cervix
  • Cervical cancer

The good news is that in many cases the bleeding will resolve on its own. However, in some cases it could be indicative of more serious conditions, especially for those who are post-menopausal. If you’re concerned about vaginal bleeding, believe you've been exposed to an STI, or have other symptoms, it might be good to talk with a health care provider or gynecologist. They’ll likely ask you for details about the bleeding, including questions about the color and flow of blood. They may also perform a physical examination to determine whether the bleeding is coming from your vagina, cervix, vaginal walls, inner labia lips, or urethra. The information you provide may help your provider diagnose or rule out other possible causes of your vaginal bleeding and offer an appropriate treatment to reduce or eliminate it.

Take care,

Last updated Jan 15, 2021
Originally published Sep 05, 2003

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