Is it normal to bleed after sex?

Bleeding from inside the vagina after penetrative sex is called post-coital bleeding, and is more common than you might think. There are plenty of reasons why it might be happening – from vaginal dryness to untreated Sexually Transmitted Infections (STIs).

Below we discuss some of the common causes of bleeding after sex, how to know what’s normal and what’s not, and how to prevent it from happening.

Causes of bleeding after sex

Bleeding after sex can be a sign of a health condition such as:

• A Sexually Transmitted Infection (STI) including Chlamydia, Gonorrhea, or Mycoplasma Genitalium. Don’t worry though – most STIs are quick and easy to treat, usually with a course of antibiotics
• Pelvic Inflammatory Disease (PID), which is an infection of the uterus (womb), fallopian tubes and ovaries that can cause infertility and ongoing health problems. PID is often caused by untreated STIs, which is why it’s so important to get tested regularly (even if you’re practicing safe sex or think you aren’t at risk)
• A cervical ectropion or cervical polyps can also bleed with contact during sex. These aren’t STIs but should be reviewed by a doctor
• Cervicitis is an inflammation of the cervix, the lower, narrow end of the uterus that opens into the vagina. This can also be the result of untreated STIs
• Thrush is a yeast infection experienced by lots of people with vaginas. It’s easy to treat with over-the-counter medicines from your local pharmacy, but it is still advised to see a doctor if you think Thrush might be the cause of your bleeding (to make sure it’s nothing more serious)
• In rare cases, bleeding after sex can be a sign of cervical or vaginal cancer, although this is much rarer than some of the above causes
• Post-coital bleeding can also happen if there’s damage to the vagina during sex. Use plenty of lube and listen to your body. Penetration shouldn’t hurt. If it does you may need to stop or slow down

How can I tell if the bleeding is normal?

If you’re having sex during or just before/after your period, it is likely that any bleeding after sex is related to your menstruation cycle. Also, if you’re having painful sex or rough/vigorous sex and you can feel a lot of friction it is possible that the bleeding is caused by friction or tears to the vaginal area.

However, if you’re bleeding after sex – and it’s not related to either of the above – it’s recommended to book an appointment with your doctor as soon as you can, to help figure out the cause and get you any treatment that you need.

Also, if it’s happening consistently, you should also book in to see your GP. It’s better to be safe and ensure there’s no underlying health issues or risks.

You might be noticing a trend here….one of the biggest questions is when to see a doctor if you’re bleeding after sex. But the fact is, it’s never too early.

Is bleeding after sex serious?

If you’re having minor bleeding after sex and it’s not happening consistently, the chances are that it isn’t anything serious. The only way to know for sure though is to meet with your doctor. It’s always recommended to play it safe and let your doctor decide what action to take.

How to prevent bleeding after sex

There are many ways to help prevent bleeding after sex, including:

• Use lube: There are different types of lube available and water-based are the best, as they won’t damage condoms like oil-based lubes do. By lubing up you’ll reduce friction during sex, particularly if you’re having rigorous or rough sex
• Regular STI tests: Getting an STI test should be treated the same way as going to the dentist – it’s a regular health check-up to prevent any future issues and to make sure that you’re healthy. They’re also quick, easy and free with a Medicare card in NSW
• Routine Cervical Screening (previously called Pap Smears): Abnormal vaginal bleeding outside of your period is one of the earliest signs of cervical cancer. Speak to your GP and make sure that you’re up-to-date with your PAP smears (cervical screening)
• Reconsider your birth control method: Some pills, IUDs and implants can cause irregular bleeding. Chat to your GP to find out if it’s a side effect of any contraceptive that you’re taking
• Practice safe sex: Use condoms every time you have sex, to help protect you from STIs (and unplanned pregnancies of course)
• More foreplay and less friction: If you’re bleeding due to friction in the vagina, slow things down a little – enjoy more foreplay so the body is better prepared and try gentler sex

Should I bleed after having sex for the first time?

Some people with vaginas will bleed after having sexual intercourse for the first time, and others won’t. So, whatever happens – it is 100% normal. If you do bleed, it’s likely that you’ve torn your hymen which is a thin layer of skin that partially covers the entrance to the vagina.

For a lot of people though, their hymen is broken long before they have sex for the first time. It can be broken by things like using a tampon, masturbation, and even vigorous exercise like riding a horse or dancing. Remember – if you bleed after the first time, that’s fine. And if you don’t – that’s fine too. Everyone’s bodies are different.

If you do bleed, you might find that you bleed after sex the first few times. It’s your body getting used to what’s happening.

Do you have more questions? Ask Nurse Nettie – our real sexual health nurse based in Sydney – or ask a question on the Play Safe Forum.