Bleeding During Sex: What does it Mean?

The thought of bleeding during sex can feel like such a taboo – but it actually happens a lot more often than you may think!

In this article, we’ll get all of your awkward questions answered – starting with the common causes of bleeding during sex, how to distinguish between “normal” and “abnormal” bleeding, and when you should seek medical attention. We’ll also cover what you can do to prevent bleeding during sexual intercourse. 

Ready? Let’s go! 

What Does Bleeding During Sex Mean?

Bleeding during, or after, sexual intercourse affects approximately 9% of menstruating individuals and up to 63% of post-menopausal individuals. When it happens, it’s common to notice the presence of blood on the bed sheets or while urinating after sex. 

A number of factors can cause bleeding to occur during sex. This includes vaginal dryness, trauma or injury to the vaginal canal, infection, cervical issues, hormone changes, and in rare cases cancer. 

Bleeding during sex is not always a cause for concern – especially if it is light in volume and only occurs around the time of ovulation and/or your period. 

 

Common Causes of Bleeding During Sex

Vaginal dryness and insufficient lubrication

A key component of a healthy sex life is lubrication. While the vagina produces a natural lubricant when sexually aroused, sometimes it doesn’t produce enough – leading to vaginal dryness. This can cause sex to be uncomfortable and even painful, and in turn, may cause bleeding. 

Anyone can experience vaginal dryness from time to time. However, menopause, pregnancy, breastfeeding, unsafe vaginal cleaning (i.e. douching), and certain medications may cause vaginal dryness to occur more frequently. 

If you are struggling to stay lubricated during sex, there are a number of lubricants that you can try. If you are trying to conceive (TTC), we recommend using a fertility-friendly lubricant to improve your chances of conception. 

Trauma or injury

Bleeding can also be the result of physical trauma to the vaginal canal or cervix. Sometimes this can be caused by having rough sex without enough lubrication, which can cause vaginal tissue to tear during intercourse.

On a more serious note, vaginal bleeding can also be caused by sexual abuse. Victims of forced entry may experience vaginal tears that require medical treatment. 

If you have been sexually assaulted, know that you are not to blame and you are not alone. There are trained medical professionals out there ready to help you. If you’re not sure who to turn to, we recommend reaching out to a trusted friend or family member, contacting your GP, booking an appointment at your local walk-in clinic, or contacting a charitable organization (such as the Crisis Text Line) for further information and support. 

Infections and sexually transmitted infections (STIs)

According to the Mayo Clinic, infections such as chlamydia, gonorrhea, and herpes may cause cervicitis, vaginitis, endometritis, and pelvic inflammatory disease (PID) – all of which are possible causes of vaginal bleeding. 

If left untreated, infections in the pelvic area can cause permanent damage to the reproductive organs, which may lead to infertility. 

If you suspect that your vaginal bleeding is due to an infection, it’s important to seek help from a medical professional immediately. Other symptoms to look out for include pelvic pain, itching, burning during urination, unusual vaginal discharge, and the appearance of sores. 

Cervical issues

Certain cervical issues can also cause vaginal bleeding. For example, cervical ectropion is a relatively harmless condition that affects up to 50% of individuals with cervixes. In rare cases, it may cause pain or bleeding during intercourse. It can also cause bleeding between periods or during a pelvic exam. 

The presence of cervical polyps and uterine polyps can also cause bleeding during sex. 

Cervical polyps are simply mild growths of tissue in the cervix. Ovulating individuals over the age of 40 who have birthed multiple babies are more likely to have cervical polyps. Polyps are tube-shaped structures that are filled with capillaries (blood vessels) that bleed easily when touched.

Uterine polyps are smaller than cervical polyps. They are located inside the uterus and formed from the uterine lining tissue. Uterine polyps are more likely to bleed during sex and between periods. Ovulating individuals in their mid-30s to mid-50s are more likely to get uterine polyps.

Menopause and hormonal changes

Individuals who have reached menopause are more likely to bleed during or after sex. This is because estrogen levels decrease with age. This then causes the body to lower its production of cervical mucus while also causing the vaginal walls to thin – resulting in an increased risk of vaginal tearing, especially during rough sex. This condition is known as Atrophic Vaginitis, which can also cause itching and burning sensations in the vagina.

In addition to vaginal bleeding, the hormonal fluctuations of perimenopause and menopause can cause a number of other frustrating symptoms such as hot flashes, mood swings, brain fog, and insomnia to name a few. If you are unsure about your fertility status and want to know how far away you are from menopause, you may want to consider monitoring your follicle-stimulating hormone (FSH) levels with Mira. 

To learn more about the signs and symptoms of menopause, check out our article The 34 Symptoms of Menopause + 5 Treatments. 

Endometriosis

Endometriosis is a condition where tissue similar to the endometrium (uterine lining) grows outside of the uterus. This tissue can grow throughout the pelvic area – including the ovaries, fallopian tubes, uterus, intestines, bladder, rectum, cervix, vagina, and vulva. 

Common symptoms of endometriosis include:

• General pelvic pain
• Painful periods
• Painful intercourse
• Painful urination and defecation
• Bleeding during and/or after intercourse
• Bleeding between periods

Many symptoms of endometriosis can be managed with hormonal birth control. However, if you are TTC, you may wish to speak with your doctor about what you can do to maximize your chances of conception with endometriosis. Learn more by checking out our articles Endometriosis and Pregnancy: What to Expect when TTC and Can You Get Pregnant with Endometriosis? Yes – Here’s How. 

Cancer in reproductive organs

Although rare, certain cancers in the reproductive organs (such as cervical, uterine, and vaginal cancer) can all cause abnormal vaginal bleeding. 

Although symptoms can vary depending on the individual and type of cancer, the Center for Disease Control (CDC) lists the following as the most common symptoms of gynecologic cancers: 

• Abnormal vaginal bleeding (i.e. during sex or between periods)
• Pelvic pain, abdominal pain, and/or bloating
• Constipation
• Frequent need to urinate

It’s important to never skip your annual checkup with your doctor. They will conduct the appropriate tests and screenings depending on your age, symptoms, and medical history. If your symptoms are sudden and/or painful, speak to your healthcare provider immediately. 

When Should I Seek Medical Attention? 

In the majority of cases, light bleeding during or after sexual intercourse is not always a cause for concern, especially if it is not a regular occurrence. 

However, bleeding during sex could be a cause for concern if you experience any of the following symptoms: 

• Regular bleeding after sex
• Heavy bleeding after sex
• Pain, itchiness, or a burning sensation while urinating after sex

If these symptoms sound familiar, we recommend seeking immediate help from your doctor or a medical professional. They can provide you with the best care for your individual situation. 

How to Prevent Bleeding During Sex

Bleeding during sex is not always preventable, and in many cases, it’s perfectly harmless. However, there are certain things you can do to prevent abnormal bleeding during sex. 

Promoting vaginal health

Maintaining good hygiene practices is absolutely crucial for overall vaginal health and the prevention of unwanted bleeding during intercourse. 

Here are just a few quick tips to bear in mind:

• Use warm water and unscented soap when washing the outside of your vagina (i.e. the vulva) during your routine shower/bath. 
• Never use a “douche”. Your vagina can clean itself, and douching can lead to the growth of bacteria and infection. 
• Wear breathable, cotton underwear and change it daily to limit moisture and prevent the growth of bacteria. 

It’s also important to maintain good vaginal hygiene during your period. Always follow the directions closely when using pads, tampons, and other menstrual products; making sure to wash your hands before and after use. 

Safe sexual practices

Practicing safe sex is another great way to prevent abnormal bleeding during intercourse. One way to do this is by using lubricants to prevent vaginal dryness and irritation. It’s also a good idea to use protection (i.e. condoms) when having sexual intercourse – especially if you have multiple sexual partners. This is the most effective way to protect yourself from contracting an STI. 

To prevent trauma or injury to the vagina, make sure that you and your partner are on the same page about sex. Boundaries and preferences may change over time, so try to keep an open dialogue with your partner about your expectations and what you’re comfortable with. Some couples find it helpful to have a “safe word”, which lets their partner know when sex becomes too rough or if they wish to stop having sex. 

Regular health check-ups

Routine health check-ups and gynecological examinations also play a critical role in helping you maintain good vaginal health. Check-ups are not only a great opportunity to ask questions about specific symptoms, but they also allow your doctor to screen for and detect potential issues that you may not even know about. 

Early detection empowers your doctor to treat an issue early, before it becomes a more serious concern for your overall health (and fertility goals if TTC). 

Common screenings for ovulating individuals include a pap smear, vaginal exam, and STI testing as needed.  

Frequently Asked Questions (FAQs)

What are the common causes of bleeding during sex?

The most common causes of bleeding during sex include vaginal dryness, trauma or injury to the vaginal canal, infection, cervical issues, hormone changes, and in rare cases cancer. 

Is bleeding during sex always a cause for concern?

No. Bleeding during sex is not always a cause for concern. For example, in cases where it is light in volume, occurs around ovulation and/or your period, and does not occur very often. 

How can I differentiate between normal and abnormal bleeding?

Bleeding during or after sexual intercourse could be considered “normal” if it:

• Does not occur very often
• Is light in volume
• Occurs around ovulation and/or your period
• Is not accompanied by any other symptoms that interrupt your day-to-day life

Bleeding during or after sexual intercourse is considered “abnormal” if it:

• Occurs regularly
• Is heavy in volume
• Is accompanied by other symptoms such as pelvic pain, itchiness, burning sensation while urinating, and abnormal discharge

When should I seek medical advice for bleeding during sex?

If bleeding has occurred during or after sexual intercourse, you should seek medical advice immediately if:

• The bleeding is heavy in volume
• You have recently had unprotected sex
• You have recently experienced a sexual trauma
• You have reached menopause (or are approaching the age of menopause)

You should also seek medical attention if bleeding is also accompanied by symptoms such as pelvic pain, itchiness, burning sensation while urinating, and abnormal discharge. 

Can hormonal imbalances contribute to bleeding during sex?

Yes. Hormonal imbalances can cause the vaginal wall to thin and the production of cervical mucus to decrease. Both of these factors can lead to tearing inside the vagina, which may cause bleeding during sex. 

How can I prevent bleeding during sex in the future?

To prevent abnormal bleeding during sex, make sure to practice good vaginal hygiene, engage in safe sexual practices with your partner(s), and always attend your annual check-up with your doctor.