We at Bustle love giving you tips for how to tap into your sexual potential and troubleshoot when things aren’t going your way in the bedroom. But what about finding solutions to those stressful sexual health situations that inevitably crop up when you’re getting down? Emma Kaywin, a Brooklyn-based sexual health writer and activist, is here to calm your nerves and answer your questions. No gender, sexual orientation, or question is off limits, and all questions will remain anonymous. Please send your questions to firstname.lastname@example.org. This week’s topic: reasons you may be bleeding during or after sex.
Q: Sometimes after I’m done having sex, I notice that I’m bleeding a little out of my vagina. It’s not when I’m having period sex. Just regular times. It’s not, like, gushing, but there’s definitely blood when I wipe myself after sex and sometimes I even notice a bit of blood on my boyfriend’s condom. I haven’t gone to the doctor because the bleeding doesn’t continue, but last night I started freaking out a bit that maybe I’m actually in danger, or I'm having sex too hard. Could this be medically significant? No one ever told me about bleeding after sex.
A: While we don’t talk about it in sex ed class for some reason, bleeding during or after sex (particularly penis-in-vagina penetrative sex) is actually very common. Your vagina, while a total badass that can squeeze out a tiny human all by itself, is also made of pretty tender material. It’s sensitive up in there, which is a big part of why it feels so good. But it also means that when it’s banged around, there can be a bit of blood. Your vaginal canal is also connected to a bunch of other delicate and complex areas, and disruption of those can result in some bleeding.
The important thing to know is that there are a bunch of reasons why you could be noticing some blood after a sexy romp. Many of these are totally not serious, but for some you will want to get medical treatment. To know the underlying cause of the bleeding, you have to visit your doctor.
So let’s get to it. Why might you be experiencing post-sex bleeding?
1. You're Not Lubricated Enough
Vaginas are self-lubricating, it’s true. However, not everyone makes enough of their own natural lube to make sex slippery enough to feel great — or protect the delicate vaginal membranes. It’s important to have enough lubrication in your vagina to protect your skin, so it doesn’t get chafed by the in-and-out friction you’re generating. Friction can result in tiny tears, which in turn can result in blood.
If you don’t make enough lubrication on your own (no shade, everyone’s different and some people are different day-to-day, based on their menstrual cycle, how they’re feeling that moment, you name it) you can always add some store-bought personal lubrication into the mix. It’s also good to remember that vaginas often take a bit of time to get going — so don’t forget that foreplay!
2. Your Cervix Was Rubbed
In penetrative sex, sometimes your cervix can get rubbed. This doesn’t happen in all positions, but it’s pretty common. Most post-sex bleeding comes from your cervix getting rubbed or hit during sex — not in a way that is uncomfortable at the time, but with enough friction or bumping to cause it to bleed a wee bit.
If this freaks you out or becomes unpleasant, you can always experiment with positions that aren’t as deep, so that your cervix doesn’t get touched as much.
3. You're Actually On Your Period
This may seem obvious, but sometimes when you notice blood in your vagina, it’s because you’re on your period. It could be the start of your period, so the blood is unexpected, or it could be a bit afterwards, when you thought you were done but lo and behold — there’s still more left inside! This is totally normal and there’s not much you can do about it, other than putting in a vaginal sponge if you are really squidged out by having period blood included in your sexual experience.
4. You're Having Sex For The First Time
It's commonly believed that the first time you have penis-in-vagina sex, you will bleed — because your hymen, a bunch of thin membranes up in there, will break (thereby "popping your cherry"). This is actually a misconception, because your hymen wears away naturally over time. This means there's also a big chance you won't bleed at all your first time — depending on how old you are when you start having penetrative sex, and what else you've been up to in your life (riding lots of horses or bikes, for example).
It is true that if you start having sex when your hymen hasn't worn away yet, it can tear and you can bleed a bit. Remember that for the vast majority of people, the hymen always has a hole in it — that's how menstrual fluid and vaginal discharge get through! Most likely, this isn't the reason you're bleeding during sex.
5. You Have Microtears
Some of us like our sex rough, and sometimes sex gets rougher than we intended. Rough sex can result in tiny tears in your vaginal walls, which can in turn result in bleeding. The walls and opening of your vagina can also get injured, causing bleeding.
The good news is that your vagina will heal itself quickly. The less good news is that if you’ve had rough sex and as a result have some tears, it’s probably going to hurt if you try to have sex again before you’re healed. And of course, if your tears are the result of sex you did not want, they can be of a more intense nature and can be accompanied by other physical and emotional symptoms of trauma. (If this is you, remember that there is help and support out there.)
6. You Have Vaginitis Or Cervicitis
These words both sound kinda stressful, but "-itis" just means the word it’s modifying is inflamed or infected. So vaginitis is inflammation or infection of the vagina, and cervicitis is inflammation or infection of the cervix. This can cause changes in vaginal discharge, itching, and pain (for vaginitis), and changes in vaginal discharge and bleeding (for cervicitis). Both can cause bleeding after sex.
Causes can include bacterial infection (such as through an STD) but also just normal changes in your body during your period or as you age. To figure out the culprit for your vaginitis or cervicitis, should you have either, you’ll need to work with your doctor.
7. You Have Cervical Ectropion
Cervical ectropion, also called cervical erosion, is when the cells that are normally inside the lining of your cervix poke out around the cervical opening. These cells were designed to be protected inside your cervix, so when they are outside in the great big world of your vagina, they can get inflamed and may bleed more easily.
This cervical cell situation is most often dealt with by adolescents, folks on oral birth control, or people who are pregnant. Sometimes you may need treatment to fix it, which can include freezing or cauterizing the cells. However, for some people, it just goes away on its own.
8. You Have An STD
Some sexually transmitted diseases have the side effect of potential vaginal bleeding after sex — along with a slew of other symptoms. Chlamydia and gonorrhea are bacterial infections that impact the cervix, causing bleeding as well as other unpleasant side effects such as itching, burning, changes to your vaginal discharge, and pelvic pain. If you have one of these infections, you can get antibiotics from your doctor to get cured, which should do away with the bleeding.
Another STD that can cause vaginal bleeding is trichomoniasis, a rather unknown STD that’s actually a tiny parasite. Trichomoniasis infection can lead to vaginitis, which as we now know can cause vaginal bleeding during sex. Trichomoniasis is easily cleared up with an antibiotic, so if you notice that in addition to postcoital bleeding your vagina is itchy, it hurts when you pee, and your discharge is smelly, frothy, foaming, and either yellow or gray-green, talk to your doctor to get tested.
9. You Have A Benign Growth
We tend to think of any growth that’s not supposed to be in our bodies as something really scary, but many growths are not cancerous and are often just annoying. You can get these benign polyps on your cervix or uterus, and these can cause bleeding during sex because they are fragile little things that bleed when touched. Polyps can go away on their own, but sometimes they have to be removed with surgery. Luckily, this removal is easy and painless in most cases.
10. Your Estrogen Is Low
Low estrogen can cause a host of physical and emotional challenges, one of which is bleeding during sex. This actually happens because estrogen helps keep your vagina walls thick and strong. Lowered estrogen can result in thinner vaginal walls, which can result in inflammation or infection — and in turn, can result in vaginal bleeding during sex.
11. You Have Endometriosis
Endometriosis is a condition wherein the lining of your uterus (called your endometrium) grows outside your uterus. This is problematic because these cells still act like endometrial cells, causing all manner of unpleasantries, mostly severe pain-related. When these uterine cells jump ship and attach to the cervix or vagina, they can bleed during sex.
Endometriosis is not the easiest condition to treat, or even know you have. For your doctor to diagnose it, she has to do exploratory surgery to test the cells and see if they are endometrial. However, good doctors can make a solid guess, and once they’re inside you they can take out all the offending cells.
12. You Have Cervical Dysplasia
Cervical dysplasia is what doctors call precancerous changes to the cells inside your cervix. So this isn’t cancer, but it is an indication that in the future there is a chance you could get cervical cancer. This is what pap smears are looking for when you get them every couple of years. One of the ways to indicate that you have these abnormal cells is if you have postcoital bleeding.
The point is to catch these precancerous cells when they are just abnormal, before they develop into cancer. Usually these cells will go away on their own — it’s only rarely that they actually end up cancerous. But if your bleeding after or during sex is frequent, you should see a doctor just to make sure.
13. You Have Cancer
Finally, the scary one. Postcoital bleeding can indicate that you have vaginal, cervical, or uterine cancer. This is by no means the first culprit your mind should jump to when you notice a bit of blood on your sheets after sex, but it is a potential cause.
This is why if bleeding during or after sex is a common occurrence for you, you’ll need to go to your doctor to make sure. She will do a number of tests to see if you have cancerous cells. Even if you do end up with cancer cells in your body, it’s by no means a death sentence. There are many treatments for these cancer types.
The Bottom Line
There are so many reasons why you might be experiencing a bit of blood during or after sex. In most cases, the reason isn’t medically serious or scary. Most times, the bleeding will go away on its own. In the cases that there is something more frequent and potentially serious is going on, it’s important to go to the doctor to figure out precisely what — because particularly in the case of cancer, the earlier you catch it the better off you’ll be!
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