Vaginal bleeding after sex: Causes, Symptoms, Tests & Examinations

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Vaginal bleeding after sex is common and can happen when you’re not menstruating or don’t expect to be menstruating. Although it’s often called “vaginal” bleeding, the term refers to bleeding from the vagina as well as bleeding from other parts of your genital and urinary systems.

Vaginal bleeding after sex occurs most often in younger, premenopausal women and doesn’t necessarily mean that you need to see a doctor. But vaginal bleeding after sex in older, postmenopausal women is less common and warrants a visit to your doctor to find out what’s causing it.

Causes of bleeding after sex

Bleeding after sex can be a sign of a health condition:

  • an infection, such as pelvic inflammatory disease (PID), or a sexually transmitted infection (STI), such as chlamydia
  • vaginal dryness (atrophic vaginitis) caused by reduced vaginal secretions after the menopause
  • damage to the vagina, such as tears caused by childbirth, or by dryness or friction during sex
  • cervical or endometrial polyps (benign or non-cancerous growths in the womb or the lining of the cervix)
  • cervical ectropion (also known as cervical erosion), where there is an inflamed area on the surface of the cervix

In rare instances, bleeding after sex can be a sign of cervical or vaginal cancer.

Symptoms of bleeding after sex

Bleeding after sex may occur with other symptoms depending on the underlying disease, disorder or condition. For example, bleeding after sex due to vaginal dryness may occur with other symptoms of menopause, such as mood swings and cessation of menstrual periods.

Symptoms that may occur along with bleeding after sex

Bleeding after sex may occur with other symptoms including:

  • Difficulty getting pregnant or infertility
  • Fever
  • Lower back pain
  • Nausea and vomiting
  • Painful bowel movements
  • Painful sexual intercourse
  • Pelvic or abdominal pain or cramps
  • Symptoms of menopause (cessation of menstrual periods, loss of sexual desire, vaginal dryness)
  • Unusual vaginal discharge

Symptoms that might indicate a serious or life-threatening condition

In some cases, bleeding after sex can be a sign of a serious or life-threatening condition, such as cervical cancer, a sexually transmitted disease (STD), or uterine cancer. Seek immediate medical care (call 911) if you have any of the following symptoms:

  • Dizziness
  • High fever (higher than 101 degrees)
  • Severe pelvic or abdominal pain
  • Severe or heavy vaginal bleeding
  • Vaginal bleeding during pregnancy

Tests and examinations

Depending on any other symptoms and your medical history, your GP may recommend some tests or examinations, such as:

  • a pregnancy test (depending on your age)
  • a pelvic examination (where the GP inserts two fingers into your vagina to feel for anything unusual)
  • looking at the cervix with an instrument called a speculum

If the problem is caused by vaginal dryness, they may recommend that you try using lubricating gels.

You may also be referred to a specialist, such as a gynaecologist or genitourinary specialist.

Cervical screening tests

It’s important that all women aged 25 to 64 get regular cervical screening tests to help prevent cervical cancer.