Bleeding after sex: is it normal and what could it mean?

Bleeding after sex is not normal. If you experience bleeding after sex, you should see your GP to find out the cause. 

Causes of bleeding after sex

Causes of bleeding after sex include infections, vaginal, labial or anal tears, polyps in the uterus (womb) or cervix (neck of the womb), and cancers (most commonly of the cervix). Usually bleeding after sex is not caused by cancer, but it is important to exclude this. 

Risk factors for bleeding after sex

Having unprotected sex increases the risk of infection and so can increase the risk of bleeding after sex. 

Having sex before you are fully aroused increases the risk of bleeding after sex.  Anything that causes the vagina, vulva or anus to become particularly dry can increase friction during sex and consequently the risk of bleeding. This is most common after childbirth, during menopause and after using female hygiene products. 

Oestrogen-based contraception (pills, rings and patches) can increase your risk of bleeding after sex by causing cervical ectropion, where cells that line the inside of the cervix grow on the outside of the cervix. This can be alarming but cervical ectropion does not cause or increase your risk of cervical cancer. 

Having uterine or cervical polyps also increases the risk of bleeding after sex. 

Cancer of the cervix, and less frequently cancer of the vagina, uterus or anus, increases the risk of bleeding after sex too. 

Investigating the cause of bleeding after sex

Your doctor will ask you about your symptoms and how long they have been going on, as well as your medical history and any recent changes in your life that may be related to your symptoms. 

They may perform a physical examination to look for new lumps or bumps. Your doctor will inspect the skin around the vulva, vagina and anus first. In individuals with a cervix, an internal examination will be offered — this may involve gently inserting a gloved finger into the vagina to feel its walls, and then, using a speculum (a duck-bill-shaped device), to look at the cervix. 

During this physical examination, swabs of vaginal discharge from the vaginal walls may be collected and sent to a lab for testing. A urine test and blood tests may be offered.  An ultrasound scan of the uterus may also be arranged. 

How to reduce your risk of bleeding after sex

Using condoms can help reduce the risk of infection by providing a physical barrier against STIs, which are a common cause of bleeding after sex. 

During sex, lubrication is important and can help prevent bleeding after sex. You may want to consider buying a lubricant to help with this. Avoiding using feminine hygiene products can be helpful too.  

After menopause, people with a cervix and vagina sometimes bleed due to a reduction in the hormone oestrogen. This can be addressed by using hormone replacement therapy but should always be investigated by a GP first to exclude other causes of bleeding.   

For individuals with a cervix, you can also reduce your risk of bleeding after sex by keeping up with regular cervical screening. This is offered for free on the NHS to individuals with a cervix aged between 25 and 64. 

Cervical screening helps reduce the risk of cervical cancer by testing for infection with human papillomavirus, which is the leading cause of cervical cancer. If you test positive, you will be more closely monitored so that any abnormal cells can be detected early and removed.