If you’re not anywhere near your period, it might feel alarming to see a bit of blood after you’ve had sex. You might even wonder if it means something serious.
Fear not: Vaginal bleeding after sex (also called postcoital bleeding) is actually pretty common. In fact, light bleeding after sex happens to up to 9 percent of all menstruating people. And most reasons are not cause for concern.
“There are many causes of postcoital bleeding,” says Jamy Bulgarelli, DO, OB/GYN at Pediatrix Medical Group in Grand Prairie, Texas. “But most causes are benign.”
Learn the most common causes of bleeding after sex here, along with other signs and symptoms to watch for, and how to treat each.
1. Vaginal infections
One of the most common causes of bleeding after sex is a vaginal infection, says Dr. Bulgarelli. There are several different pathogens that can cause vaginal infections, with the most common being STIs like chlamydia, gonorrhea, trichomoniasis, and herpes. Less commonly, yeast infections or an infection called bacterial vaginosis (BV) can cause bleeding after sex, says Dr. Bulgarelli.
“Infections, particularly sexually transmitted ones, can lead to significant inflammation of the cervix (cervicitis), making it more prone to bleeding during or after intercourse,” explains Dr. Bulgarelli. “Common symptoms of these infections include abnormal vaginal discharge, vaginal odor, itching or irritation, urinary symptoms, and pelvic pain.”
Some people may even bleed after sex without pain or other symptoms, she says.
Fix it
If you think you might have an STI or other infection, see your OB/GYN for testing.
Treatment for vaginal infections depends on the type of infection you have. STIs and BV are treated with antibiotics or antiviral medications, while vaginal yeast infections are treated with topical or oral antifungal medications.
2. Vaginal dryness
Vaginal dryness is a common cause of bleeding after sex, says Kelly Culwell, MD, OB/GYN, also known as Dr. Lady Doctor. Dryness “makes the vagina more sensitive and vulnerable to irritation or tears during vaginal intercourse,” she explains.
While natural lubrication of your vaginal walls can ebb and flow throughout the month, extreme dryness usually happens when your estrogen levels are low, says Dr. Culwell, like during menopause or perimenopause (i.e., the transition to menopause). According to the American College of Obstetricians and Gynecologists (ACOG), lower estrogen levels are also common after childbirth and during the postpartum period, as well as while you are breastfeeding or chestfeeding.
Fix it
Add some moisture to your vagina by applying a lubricant before sex.“There are also vaginal moisturizers that can be used on a regular basis (not just before sex), especially if your dryness is bothersome at any time of day,” notes Dr. Cullwell. One to try? Foria’s Midlife Magic set.
3. Vaginal atrophy
During perimenopause, your vaginal tissues might get thin and delicate, less elastic, and vulnerable to tears, otherwise known as vaginal atrophy, says Alyssa Dweck, MD, chief medical officer at Bonafide Health. When combined with low estrogen levels and vaginal dryness, you may become more likely to bleed after sex.
“Blood might be bright red with a moderate flow, or pink with light flow, and is usually accompanied by pain or burning,” says Dr. Dweck.
Fix it
Just like with dryness, bleeding from vaginal atrophy can be prevented by using a vaginal lubricant. Dr. Dweck suggests finding a vaginal moisturizer with hyaluronic acid as a main ingredient. Getting prescribed a vaginal estrogen cream by your gynecologist can also be helpful, she adds.
4. Vaginal or anal tearing
Vaginal bleeding can happen as a result of rough sex, anal sex, or having sexual intercourse for the first time, says Ila Dayananda, MD, MPH OB/GYN and chief medical officer of Oula Health. This is usually due to the sensitive tissue in your genital or anal area tearing or becoming damaged.
Fix it
“If bleeding is from rough sex, allowing time for healing and practicing gentler sexual activity may resolve the issue,” says Dr. Dayananda. “Lubricants may also be helpful.”
In some cases, hormone therapy combined with lubricants and moisturizers can alleviate symptoms, especially if you are in perimenopause. But of course, talk to your doctor to see whether hormone therapy is right for you.
5. Cervical polyps
In some cases, bleeding after sex can be from small (typically harmless) growths on your cervix called cervical polyps, says Dr. Dweck.
“Bleeding [from polyps] is usually bright red and can cause significant flow for some people,” she adds. Even though the causes of cervical polyps aren’t fully understood, they are fairly common, says Dr. Dweck.
Fix it
Cervical polyps are often found during a routine gynecologic exam, a colonoscopy, or a transvaginal ultrasound, according to the National Library of Medicine.
“While most polyps will fall off or go away on their own, some can grow quite large and may require surgical removal,” says Dr. Dweck. Some people may need to see the doctor on a regular basis to keep an eye on them.
If you think polyps are the culprit, make an appointment with your gynecologist to get them checked out.
6. Pregnancy
Vaginal bleeding while pregnant always warrants a trip to the OB/GYN. But believe it or not, light bleeding or spotting during the first trimester of pregnancy is actually quite common. In fact, about 15 to 25 percent of pregnant people bleed during the first trimester, according to ACOG.
This can be from the implantation of the fertilized egg in your uterus, or extra blood flow to your cervix, which can make you more vulnerable to vaginal bleeding, per ACOG. Spotting while pregnant can also happen during a pelvic exam or after sex.
Fix it
Even though light vaginal bleeding in your first trimester is not harmful, you should still let your OB/GYN know when it happens. They can help you rule out any potentially serious causes of bleeding, just in case.
7. Rarely, it could mean cervical cancer
It’s pretty rare, but bleeding after sex can sometimes mean cancer, says Dr. Dayananda. You’ll likely have other symptoms besides postcoital bleeding, like abnormal bleeding between periods or bleeding after menopause, she adds. “Some people may also have pelvic pain or pain during sex,” she adds.
Risk factors for cervical cancer include smoking, a previous chlamydia infection, long-term birth control use, and a family history of this type of cancer. The greatest risk factor, though, is the human papillomavirus infection (HPV), which is why regular screenings for HPV and regular pap smears are important, per the American Cancer Society.
Fix it
Make sure you’re getting routine pap smears and HPV screenings, as these can help detect cervical cancer in its early stages and prevent serious cases. “Early detection is crucial for better outcomes,” emphasizes Dr. Dayananada.
And of course, be sure to bring up any “out of the ordinary” symptoms you’re feeling to your gynecologist.
When to see a doctor
Most of the time, vaginal bleeding after sex is a one-time deal and isn’t cause for concern, says Dr. Bulgarelli. But if your bleeding persists, happens every time you have sex, or is very heavy, reach out to your doctor.
You should also call the doctor if bleeding comes with other symptoms like vaginal discharge, pelvic pain, and unusual odors, adds Dr. Bulgarelli. This is especially true if you’re past menopause and have vaginal bleeding, regardless of frequency or severity.
The bottom line? Many people with vaginas experience bleeding after sex at one point or another. So no need to panic! If you’re ever unsure, though, you can always call your doctor about your symptoms and schedule an appointment.
