Bleeding after sex
Bleeding after sex, called postcoital bleeding, usually comes from the cervix or vagina rather than the uterus. The cause is usually treatable, but it needs a check because some causes are infections or cervical changes.
Common causes
- Infection of the cervix, including chlamydia, gonorrhea, and trichomoniasis
- Cervical ectropion, where softer cells from inside the cervix sit on its surface
- Cervical or endometrial polyps
- Vaginal dryness or thinning, especially after menopause or while breastfeeding
- Minor tears from friction
- Less commonly, precancerous changes or cancer of the cervix
What evaluation usually involves
Expect testing for sexually transmitted infections, a pregnancy test, and a check that your cervical screening (Pap and HPV testing) is current. A pelvic exam to look at the cervix is usually needed and happens in person. If screening is abnormal or the cervix looks unusual, the next step is colposcopy.
By video, we can start the evaluation, order STI testing, review your screening history, and arrange the in-person exam.
Sources
- American College of Obstetricians and Gynecologists. Practice Bulletin No. 128: Diagnosis of abnormal uterine bleeding in reproductive-aged women. Obstet Gynecol. 2012;120(1):197–206 (reaffirmed).