- Bleeding during or after intercourse, often termed post-coital bleeding, can occurbecause of many reasons. Cervical cancer is one of the most serious causesof post-coital bleeding. However, it is not the only cause. In fact, lessthan 6 percent women presenting with post-coital bleeding are likely to bediagnosed with invasive cancer. Some of the more common causes of bleedingassociated with intercourse are precancerous changes in the cervix, cervicalectropion, infections and inflammation. Whatever the cause of bleedingassociated with intercourse, it is not a symptom that you should ignore.It is advisable to contact your doctor at the earliest if you areexperiencing bleeding during or after intercourse.
- Bleeding during or after intercourse, often termed post-coital bleeding, can occurbecause of many reasons. Cervical cancer is one of the most serious causesof post-coital bleeding. However, it is not the only cause. In fact, lessthan 6 percent women presenting with post-coital bleeding are likely to bediagnosed with invasive cancer. Some of the more common causes of bleedingassociated with intercourse are precancerous changes in the cervix,cervical ectropion, infections and inflammation. Whatever the cause ofbleeding associated with intercourse, it is not a symptom that you shouldignore. It is advisable to contact your doctor at the earliest if you areexperiencing bleeding during or after intercourse. Some of the commoncauses of bleeding during sex are discussed below.
- Bleeding after intercourse could be a sign of cervical dysplasia, also calledcervical intraepithelial neoplasia (CIN). Cervical dysplasia means thepresence of abnormal cells in the cervix. Depending on the extent and typeof the abnormality, cervical dysplasia may progress to cervical cancer.Low-grade cervical dysplasia usually resolves without any treatment.High-grade dysplasia has a significant chance of progressing to cervicalcancer. Not all women with cervical dysplasia have bleeding or spottingafter sex. It is a silent condition in a vast majority of cases, detectedonly through a pap-smear.
- Post-coital bleeding is regarded a characteristic symptom of cervical cancer, thoughit may not be present until advanced stages of the disease. Widespread useof regular pap smears has reduced the incidence of cervical cancer indeveloped countries, but it remains among the leading cancers affectingwomen worldwide. Cervical cancer is most often seen in women more than 40years of age. Other symptoms of cervical cancer may be bleeding betweenperiods, post-menopausal bleeding, increased vaginal discharge, and painduring intercourse. Human papillomavirus (HPV) infection is an underlying factorin nearly all cases of cervical cancer.
- Cervical ectropion is a condition in which the tissue lining the inner side of thecervix comes out onto the outer surface of the cervix. Since this tissue(columnar epithelium) is much thinner than the tissue that normally coversthe outer surface of the cervix, underlying blood vessels show through it,making it red in appearance and also prone to bleeding.
- Cervical ectropion is also called cervical ectopy or cervical erosion. It is not apremalignant condition and does not develop into cervical cancer. Use oforal contraceptive pills, childbirth and miscarriage are some of thereasons that could lead to cervical ectropion
- Asymptomatic cervical ectropion does not require treatment. Cervical ectropionproducing bothersome degree of vaginal discharge or post-coital bleedingcan be treated with either freezing (cryotherapy) or cauterizing(diathermy). The procedures are painless and do not requirehospitalization.
- Cervical polyps are benign growths in the cervix. They are a rather common cause ofbleeding after sex. Polyps may occur alone or in groups. Most polyps are 1to 2 cms in length. It is usually not possible to feel the polyps on yourown. Other associated symptoms are bleeding between periods, vaginaldischarge that can at times have a foul smell, and heavy periods. Thetreatment is removal of the polyp.
- Women having sexually transmitted diseases such as chlamydia and gonorrhea mayhave bleeding after intercourse. These are bacterial infections for whichseveral effective medications are available. Another infection calledtrichomoniasis may also be associated with bleeding after intercourse.
- Estrogen is the chief hormone required to keep the vaginal tissue moist andelastic. As the levels of this hormone fall with menopause, the mucusmembranes produce less lubrication, making the vagina very dry and thin.This condition is also called atrophic vaginitis. It can occur because ofother causes as well, but is mostly associated with menopause. Thin anddry vagina is more prone to injury during intercourse which can lead topain and at times, bleeding. Your doctor can prescribe adequateover-the-counter lubricants to relieve your condition. Some women benefitfrom hormone replacement therapy.
- Vaginal yeast infection can also sometimes be associated with bleeding afterintercourse. Other symptoms of yeast infection are itching and burningsensation along with an odorless, white, cheese-like discharge.
- Uterine polyps are an overgrowth of the endometrial tissue. The chief symptom ofuterine polyps is bleeding between periods. They may also cause bleedingor spotting after sex, spotting, heavy periods, bleeding after menopause,and breakthrough bleeding in women receiving hormone therapy.
- Uterine fibroids are mostly benign tumors made of fibrous tissue. In some casesfibroid tumors do not produce any symptoms. In other women they can beassociated with a variety of symptoms including bleeding afterintercourse.
- Endometritis is an inflammation of the inner lining of the uterus. Adenomysis is acondition in which endometrial tissue attaches itself to the uterus, orgrows outside the uterus attached to another organ such as the ovaries.Both the conditions can lead to bleeding after intercourse. A thoroughgynecological examination is required for diagnosis.
- The hymen is a small tissue that lies across the entrance to the vagina. Minorbleeding because of tearing of the hymen is common at first intercourse.The elasticity of the hymen varies from one woman to another. Not allwomen bleed at their first intercourse, so it is not medically correct tosee bleeding as evidence of virginity. Many a times the hymen may havebeen broken by vigorous exercise, tampon use or by injuries such as thestraddling of a bike. Moreover, the amount of bleeding from a torn hymenmay be too minor to be noticed. Normal bleeding caused by firstintercourse should stop within a day. If you are experiencing continuedheavy or brisk bleeding after first intercourse it is advisable to consulta doctor, particularly if there is associated lower abdominal pain. Womenwho have stinging or burning associated with minor bleeding followingfirst intercourse can use some pain killers. Avoiding further intercoursetill bleeding stops and using extra lubrication during subsequentintercourse is also advisable.