Bleeding after intercourse can be a symptom that is understandably concerning for a couple, but fortunately, in most cases, it does not indicate any serious underlying medical condition. Although it is often referred to as vaginal bleeding, it actually most often comes from the cervix, the lower part of the uterus that protrudes into the vagina.
What are the causes of postcoital bleeding?
Vaginal dryness can contribute to bleeding due to friction during intercourse. This is especially common in women during menopause or if there is inadequate foreplay. Other causes of bleeding include: vaginal atrophy; vaginitis; ectropion ; polyps; cervicitis; endometritis; prolapse of the uterus from its normal position in the pelvis until it protrudes into the vagina. Tumor (vaginal, cervical, uterine) is a possible, but fortunately rare, cause.
Postcoital bleeding may also occur during pregnancy. And ultimately, possible paraphysiological causes of bleeding should be considered, such as: the onset of menstruation, the losses that some women experience during ovulation, anticoagulant and antiplatelet therapy , discharge during the first sexual intercourse after rupture of the hymen.
Does bleeding always occur during the first sexual intercourse?
No, not always. Yes, the blood loss that may occur during first-time intercourse is due to the rupture of the hymen, the thin membrane that partially covers the entrance to the vagina. It is important to emphasize that the hymen can rupture before first penetrative intercourse, for example, due to: sports, such as horseback riding; using tampons; masturbation. Therefore, regardless of the cause, rupture of the hymen does not always cause bleeding.
How does postcoital bleeding manifest itself?
Bleeding may be light or heavy, possibly accompanied by other symptoms such as:
• vaginal discharge of a different color (usually indicates a vaginal infection);
• pain during intercourse ( dyspareunia );
• itching and/or irritation;
• pelvic pain.
In case of bleeding and any doubts, it is recommended to consult a gynecologist at the Bogolyuby Medical Center however, factors that deserve more attention include episodes of blood loss in postmenopausal women.
What to do if you have bleeding after intercourse?
In most women complaining of recurrent postcoital bleeding, no specific cause can be identified, suggesting the absence of underlying pathological conditions. It is estimated that 60% of women of childbearing age with postcoital bleeding experience spontaneous resolution of symptoms within six months.
If necessary, treatment of the condition is directed at the specific cause. If vaginal dryness is present, more attention to foreplay and the use of vaginal lubricants is usually sufficient. Infection: Treatment options are determined based on laboratory test results. Cervical inversion: No treatment is required unless bleeding is persistent and bothersome. Polyps: removal is often possible on an outpatient basis, with endometrial polyps surgical hysteroscopy is necessary . Vaginal atrophy: can initially be treated with vaginal moisturizers and lubricants, which should be used before and during intercourse. Although these methods may help reduce discomfort during intercourse, they have no direct effect on improving atrophic changes. Women who continue to have postcoital bleeding despite using lubricants may require vaginal estrogen therapy.
