Vaginal bleeding after sex

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at November 27, 2015
StartSymptomsVaginal bleeding after sex

It can be alarming for a woman to discover vaginal bleeding after sex (intercourse). This can occur for numerous reasons, some minor while others can be serious. Identifying the cause and seeking proper medical advice for prevention and treatment is essential for maintaining sexual health.

Contents

Definition & Facts

Vaginal bleeding after sex is also referred to as postcoital bleeding. This is bleeding that occurs during or after intercourse when a woman isn't menstruating. This type of bleeding is most common for women between the ages of 20 and 40. Women experiencing vaginal bleeding after sex should make an appointment with their physician or gynecologist right away.

Causes

There are a number of reasons why a woman may experience bleeding after intercourse. Sexually transmitted diseases such as chlamydia and gonorrhea may be to blame. Both are bacterial infections transmitted through contact with semen, vaginal fluid, and sexual activity.

Another infection that can affect the vagina is vaginitis, which can cause swelling to a woman's vagina or cervix. Trichomoniasis, commonly referred to as "trich," is a possible cause. It is usually contracted through intercourse, but it is possible to contract this disease via hot tubs, urine, toilet seats, swimming pools, and tap water.

Other possible causes include a vaginal yeast infection that occurs from an overgrowth of the normal fungi contained in the vaginal area, cervical dysplasia which refers to a precancerous condition which involves the growth of abnormal cells on the lining of the cervix, and uterine polyps. Uterine polyps are abnormal growths of tissue that are attached to the inner wall of the uterus and extend into the uterine cavity.

Also, women who are nearing menopause or are postmenopausal may have decreased levels of estrogen. This may cause the lining of the vagina to become thinner, making the vagina more susceptible to swelling or infection which can be associated with vaginal bleeding after intercourse.

When to see a doctor

If you are pregnant and experience vaginal bleeding after sex you should be evaluated right away. Other woman who notice vaginal bleeding either during or after sexual intercourse should schedule a visit with their physician or gynecologist to determine the cause of their bleeding as soon as possible.

This is especially true if the vaginal bleeding is accompanied by pain or discomfort, odor, fever, chills, nausea and vomiting, fatigue, dizziness or other signs of infection. Women who feel thay may have been exposed to a sexually transmitted disease should also seek prompt medical care. While it is always best to be evaluated, there are circumstances when vaginal bleeding after sex is natural and doesn't necessarily need evaluation.

This is true of women who have all three of the following characteristics: Premenopausal, experience vaginal bleeding after sex infrequently, and have had normal screenings for sexually transmitted diseases and routine Pap tests. In these cases, this type of abnormal vaginal bleeding will likely resolve on its own. Women who don't fit in the previous category will likely require some method of treatment for their underlying cause.

Failing to follow up with an examination or ignoring symptoms can worsen the problem. If the cause of a woman's bleeding is related to an infection, cancer, or other serious condition, the consequences of not seeking treatment can be life threatening.

Treatment & Therapy

If the cause of a woman's vaginal bleeding after intercourse is a bacterial infection, such as chlamydia or gonorrhea, treatment is relatively simple. Often times a physician will prescribe antibiotics to be taken over a specific length of time. The antibiotic prescribed will vary on the type of infection.

When taking antibiotics it is essential that a woman follows the instructions for dosage carefully, continuing to take the antibiotic for as long as it is prescribed, even if symptoms have resolved. If affected by trichomoniasis, which is actually an infection from a parasite, women can expect to be prescribed a pill that is taken by mouth to treat parasitic infections. Commonly prescribed medications for thichomoniasis include metronidazole and tinidazole. Metronidazole is also commonly used to treat bacterial vaginosis.

This medication is typically used once or twice daily for five to seven days. It can be in the form of a pill, a gel, or cream that is applied to the vagina. Yeast infections are commonly treated with antifungal creams or vaginal suppositories such as clotrimazole, miconazole, or tioconazole. Fluconazole, a prescription oral antifungal medication, can also be used to treat yeast infections. Many women tend to seek over-the-counter antifungal treatments as they are cost-effective, convenient, and there is no need to wait for a prescription.

However, by using over-the-counter options for self- treatment a woman could possibly mistake a yeast infection for other conditions that require different treatment. For women who experience vaginal bleeding after sex related to thinning of the vaginal lining, estrogen is commonly prescribed in the form of vaginal rings, tablets, or creams. Women who are diagnosed with cervical dysplasia are treated according to age and severity of the condition. At times no treatment is necessary and a woman is monitored with repeat Pap tests.

If treatment is necessary it may include laser surgery, electrocauterization, cryosurgery (freezing), or a cone biopsy. Uterine polyps that are small may not necessarily need treatment. However, if treatment is indicated for polyps, certain hormonal medications, including gonadotropin-releasing hormone agonists and progestin are often prescribed. If uterine polyps are causing more severe symptoms or are large in size they be removed surgically during hysteroscopy.

This is a procedure that involves the insertion of instruments via a hysteroscope. A hysteroscope is the device used by a physician to see inside a woman's uterus, and once the polyps are visible they are surgically removed.

Prevention & Prophylaxis

Prevention of vaginal bleeding after sex is dependent on the specific cause. If a sexually transmitted disease, such as chlamydia, gonorrhea, or trichomoniasis, is the cause then the best way for a woman to prevent vaginal bleeding after intercourse is by practicing safer sex. This involves talking openly with sexual partners to determine risk, avoiding sexual contact if symptoms of a sexually transmitted disease are present or if a partner has a current infection, and avoiding contact with multiple sexual partners as this can greatly increase a woman's risk of contracting a sexually transmitted disease.

Many actions can be taken by women to prevent vaginitis, with the most important one being good feminine hygiene. Women should avoid baths, hot tubs, whirlpools, douches, and irritants such as scented pads and tampons. Women can also wear cotton underwear, use latex condoms, and wipe themselves from front to back after using the toilet to prevent vaginitis. Practicing safe sex is also helpful in the prevention of cervical dysplasia as women who are diagnosed with vaginal warts are at an increased risk for this condition.

A healthy diet is also important as women who have insufficient amounts of vitamin A, folate, riboflavin, and vitamin C are at a greater risk for developing cervical dysplasia. Uterine polyps develop as a result of estrogen, a female hormone. Women at risk for developing uterine polyps are those with elevated blood pressure, obesity, and are taking chemotherapy drugs. To prevent polyps from occurring, women need to take necessary actions to decrease their risk such as maintaining a healthy diet, exercise, and weight management.