Postcoital bleeding is the medical term for bleeding from the vagina during or shortly after sexual intercourse that is not part of your normal menstrual period.
It can range from a small amount of pink or brown spotting to more noticeable bleeding. For some women it may happen once, while for others it can occur repeatedly.
There are many possible causes of postcoital bleeding. These include relatively common and harmless conditions such as cervical ectropion, vaginal dryness or cervical polyps, as well as infections and irritation or trauma. In less common cases, bleeding after sex can be associated with abnormalities of the cervix or vagina, including cervical cancer.
Most cases of postcoital bleeding are not caused by cancer, but unexplained bleeding after sex should always be assessed by a GP or appropriate healthcare professional.
At Gynae Solution, Mr Jafaru Abu will take the time to understand your symptoms, identify the possible cause and recommend any investigations or treatment that may be appropriate.
What Is Postcoital Bleeding?
Postcoital bleeding refers specifically to bleeding that occurs during or immediately after sexual intercourse and is unrelated to your period.
You may notice:
- Light spotting after sex
- Pink, red or brown vaginal discharge
- Bleeding immediately after intercourse
- Bleeding that continues for a short time after sex
- Bleeding that happens repeatedly following intercourse
Some women may also experience other symptoms, such as pelvic pain, pain during sex, unusual vaginal discharge or changes to their normal menstrual cycle.
Postcoital bleeding can happen at any age and can have many different causes.
If you experience bleeding after sex, particularly if it is new or keeps happening, it is important to have it checked rather than assuming that it is simply irritation or part of your normal cycle.
What Causes Postcoital Bleeding?
There are many potential causes of bleeding after sex. Some are straightforward to treat, while others may require further investigation.
Cervical Ectropion
Cervical ectropion is a common and harmless change to the surface of the cervix.
The delicate cells that normally line the cervical canal are present on the outer surface of the cervix. These cells can be more delicate and may bleed more easily when touched during intercourse.
Cervical ectropion can be associated with hormonal changes, pregnancy and hormonal contraception.
It does not mean that you have cervical cancer.
Cervical Polyps
A cervical polyp is a small growth that develops on the cervix.
Most cervical polyps are benign, but they can sometimes bleed when they are touched during sexual intercourse.
If a polyp is identified, your doctor may recommend monitoring it or removing it, depending on its appearance and your symptoms.
Vaginal Dryness
Vaginal dryness can make sexual intercourse uncomfortable and can sometimes result in small tears or irritation, leading to bleeding.
Dryness can occur for a number of reasons and is particularly common around and after the menopause, although it can affect women at other stages of life too.
Infection
Infections of the vagina or cervix can cause inflammation and make the tissues more likely to bleed.
Sexually transmitted infections, including chlamydia, can sometimes cause bleeding after sex. Testing may therefore be recommended depending on your symptoms and circumstances.
Friction or Trauma
Bleeding can sometimes occur because of friction or minor injury to the vaginal or vulval tissues during intercourse.
This can be more likely when there is vaginal dryness or irritation.
Hormonal Contraception
Some forms of hormonal contraception can cause changes to your normal bleeding pattern.
If you have recently started, stopped or changed contraception and have developed unexpected bleeding, your contraception may be contributing to the symptoms.
Changes to the Cervix or Vagina
Less commonly, bleeding after sex can be associated with abnormal changes affecting the cervix or vagina.
This can include precancerous changes or, rarely, cancer.
Cervical cancer can cause unusual vaginal bleeding, including bleeding during or after sex, between periods or after the menopause.
Experiencing postcoital bleeding does not mean that you have cervical cancer. There are many much more common causes. However, unexplained bleeding should be investigated so that the cause can be established.
When Should I See a Doctor?
You should arrange an appointment with your GP or a healthcare professional if you experience bleeding after sex, particularly if:
- It is new or unusual for you
- It happens repeatedly
- The bleeding is becoming heavier
- You also experience pelvic or abdominal pain
- You have pain during sex
- You have unusual vaginal discharge
- You have bleeding between your periods
- You have recently gone through the menopause
- You have other changes to your normal menstrual cycle
The NHS advises that unusual bleeding after sex should be checked, even though it is usually caused by something other than cancer.
If you have gone through the menopause, any vaginal bleeding should be assessed, including bleeding following sexual intercourse.
How Is Postcoital Bleeding Diagnosed?
The first step is understanding exactly what is happening and looking for possible causes.
During your consultation, Mr Abu may ask about:
- When the bleeding first started
- How often it occurs
- How much you bleed
- Whether the bleeding occurs during or immediately after intercourse
- Whether it happens with every sexual encounter or only occasionally
- Your menstrual cycle
- Any bleeding between periods
- Your contraceptive method
- Whether you have experienced vaginal dryness
- Pain during sex
- Pelvic or abdominal pain
- Vaginal discharge
- Your sexual health and possible exposure to STIs
- Your cervical screening history
- Any previous cervical abnormalities or treatment
- Whether you have been through the menopause
These questions help establish whether the bleeding is more likely to be related to the cervix, vagina, uterus, hormones, infection or another cause.
Pelvic Examination
A pelvic examination is an important part of assessing postcoital bleeding.
A speculum examination allows the doctor to see the vagina and cervix directly and look for possible causes such as:
- Cervical ectropion
- Cervical polyps
- Infection or inflammation
- Irritation or trauma
- Abnormal areas on the cervix
The examination should not normally be painful, although it can feel uncomfortable. You can ask your healthcare professional to stop at any time if you are uncomfortable.
NHS guidance recommends assessment of the vagina and cervix when investigating unexplained bleeding after sex.
Pregnancy Test
If there is any possibility that you could be pregnant, a pregnancy test may be recommended.
Bleeding during pregnancy can have several causes and may require a different type of assessment.
STI Testing
Depending on your symptoms and circumstances, testing for sexually transmitted infections may be recommended.
This can include testing for infections such as chlamydia.
Cervical Screening
It is important to keep your cervical screening appointments up to date.
However, cervical screening is not a test to investigate symptoms such as postcoital bleeding. If you have unexplained bleeding after sex, you should seek medical assessment rather than waiting for your next screening appointment.
Colposcopy
If the cervix looks abnormal or there is a clinical concern about cervical disease, you may be referred for a colposcopy.
A colposcopy allows a specialist to examine the cervix in greater detail using a magnifying instrument.
A small biopsy may be taken if an area looks abnormal. The sample can then be examined in a laboratory.
Importantly, being referred for a colposcopy does not automatically mean that you have cancer. The purpose is to investigate an abnormal area or symptoms more closely.
Ultrasound Scan
If the examination does not identify a clear cause, or if there are additional symptoms such as pelvic pain or abnormal bleeding, an ultrasound scan may be recommended.
A transvaginal ultrasound can provide detailed images of the womb, ovaries and surrounding pelvic structures and may help identify conditions such as fibroids, polyps or ovarian abnormalities.
Hysteroscopy
In some circumstances, a hysteroscopy may be recommended to examine the inside of the womb.
This can be particularly useful if there is concern about an abnormality within the uterine cavity, such as a polyp.
You will not necessarily need all of these investigations. The tests recommended will depend on your symptoms, examination findings, age, medical history and individual circumstances.
How Is Postcoital Bleeding Treated?
Treatment depends entirely on the underlying cause.
If no serious cause is identified and the bleeding is mild or occasional, treatment may not always be necessary.
Where a cause is identified, treatment may include:
Treating an Infection
If an infection or sexually transmitted infection is identified, appropriate treatment can usually be prescribed.
Your partner may also need testing or treatment depending on the infection.
Treating Vaginal Dryness
If vaginal dryness is contributing to bleeding, your doctor may recommend lubricants or other treatments designed to improve vaginal moisture.
For women experiencing vaginal dryness around or after the menopause, additional treatment options may be discussed depending on their individual circumstances.
Treating Cervical Ectropion
Cervical ectropion is harmless and does not always require treatment.
If it is clearly responsible for persistent troublesome bleeding, treatment to reduce the delicate tissue on the surface of the cervix may sometimes be considered.
Removing a Cervical Polyp
If a cervical polyp is causing bleeding, it may be possible to remove it using a relatively straightforward procedure.
The removed tissue may be sent to a laboratory for examination.
Treating Abnormal Cervical Changes
If investigations identify abnormal or precancerous cervical cells, further treatment may be recommended.
This can involve procedures designed to remove abnormal cells and prevent them from developing into cervical cancer.
Treating an Underlying Gynaecological Condition
If your bleeding is associated with another condition, such as fibroids, polyps or endometriosis, treatment will focus on the underlying cause.
The most appropriate treatment will depend on your symptoms, the condition identified and your individual circumstances.
Postcoital Bleeding and Cervical Cancer
It is understandable to worry about cervical cancer when experiencing bleeding after sex.
Postcoital bleeding can be a symptom of cervical cancer, but most women who experience bleeding after sex do not have cancer. The majority of cases have a benign or otherwise treatable cause.
This is why assessment is important.
If your doctor sees an area on the cervix that looks suspicious, you may be referred for urgent specialist assessment and colposcopy.
Finding cervical cancer at an earlier stage generally means that treatment is more likely to be successful, which is why persistent or unexplained symptoms should not be ignored.
Recovery and Aftercare
Your recovery will depend on the cause of the bleeding and any treatment you receive.
If your symptoms are caused by an infection, you may simply need medication and follow-up if symptoms persist.
If a cervical polyp is removed, you may experience some light bleeding or discharge afterwards and will be given advice about when you can return to normal activities.
If you undergo a colposcopy and biopsy, you may experience some light bleeding or cramping afterwards. Results from a biopsy can take some time, and your specialist will explain what happens next.
If your symptoms continue despite initial treatment, further investigation may be recommended.
Risks and Benefits of Investigation and Treatment
The benefits of investigating postcoital bleeding include identifying the underlying cause, treating symptoms and, importantly, ensuring that significant cervical or other gynaecological abnormalities are not overlooked.
Most examinations and investigations are straightforward, although a pelvic examination, colposcopy or biopsy can cause temporary discomfort.
Treatment also carries potential risks depending on what is required. For example, procedures involving the cervix can result in temporary bleeding, discomfort or infection, while more extensive surgery carries additional risks.
Before recommending any treatment, Mr Abu will explain the potential benefits, risks and alternatives so that you can make an informed decision about your care.
Specialist Care for Postcoital Bleeding
Bleeding after sex can be embarrassing or worrying, particularly when you do not know why it is happening. It is important to remember that there are many common and treatable causes, and most cases are not caused by cancer.
However, unexplained postcoital bleeding should not simply be ignored.
At Gynae Solution, Mr Jafaru Abu will listen to your concerns, carry out an appropriate assessment and recommend further investigations where necessary. The aim is to establish the cause of your symptoms and ensure you receive the most appropriate treatment.
If you are experiencing bleeding during or after sex, contact Gynae Solution to arrange a consultation with Mr Jafaru Abu.
Common questions
How soon can I be seen?
Daily appointments are available at The Park Hospital. Call the secretary on 0115 966 2049, or send an enquiry below and we will reply within 24 hours on business days.
Do I need a GP referral?
Referrals from GPs are welcome, and you can also enquire directly. If you are using private medical insurance, check with your insurer whether a referral is required for your policy. See GP referrals and fees and insurance.
What does a consultation cost?
A new consultation is £250 and a follow-up consultation is £150. The cost of any tests, procedures or surgery is quoted individually after your consultation. See fees and insurance.
Enquiries
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Enquiries from patients and referring clinicians are both welcome. We endeavour to answer all enquiries within 24 hours on business days. If your case is urgent, please say so in your message or call the secretary directly.