Why Am I Bleeding During Sex?

There are a few reasons why you might experience bleeding during or after sexual activity.

Sometimes it’s something simple. But other times, it might require a check-up from a healthcare professional.

Reason #1: Lack of lubrication

One of the most common causes of postcoital bleeding is not having enough lubrication. Think of it like rubbing two dry things together. It can cause friction and irritation.

When a penis or a sex toy goes into the vaginal canal without enough wetness, it can rub against the vaginal wall. This can cause small tears. If the penetrative sex is rough or fast, this becomes even more common.

Why might there not be enough lubrication? Here are a few reasons:

• Not aroused enough: Not fully aroused before vaginal penetration? Your body might not produce enough natural fluids.

This is called a lack of arousal or premature penetration.

• Changes during life: As women get older, their bodies make less estrogen. This is especially true around perimenopause and menopause.

Estrogen helps keep the vagina healthy and moist. When estrogen levels drop, it can lead to dryness.

When the vagina becomes thinner and drier due to low estrogen, it’s a condition called vaginal atrophy. This is the second biggest problem for women after menopause. (The first is hot flashes.)

About 75% of women experience vaginal dryness after menopause.

Know more: Perimenopause Spotting When Wiping: Is it Normal?

• Other times in life: Breastfeeding can also cause lower estrogen levels and dryness of the vagina.

Additionally, some health problems, like Sjögren’s syndrome (an autoimmune condition where the body attacks the moisture-producing glands) can make it difficult for your body to produce lubricant fluid.

If your postcoital bleeding is due to vaginal dryness, you might notice other symptoms. These include vaginal irritation and pain during sex.

One study found that about 15% of women who had postcoital bleeding also felt pain during sex.

Before you get too worried about bleeding after sex, it’s important to understand what’s causing it. Sometimes you may just not be aware of your bleeding patterns, and this is where tracking your symptoms can be helpful.

The free Inito app, which attaches to the Inito Fertility Monitor, makes this easy. You can log 20+ symptoms on the app, and this can help you see if your bleeding is related to your period, ovulation bleeding, or something else. All this information can be super helpful when you’re to understand what’s actually going on in your body.

Reason #2: Hormonal changes from birth control

Have you recently started using hormonal contraception or switched to a new type? You might experience postcoital bleeding.

This is because the hormones in birth control can cause changes in your bleeding patterns as your body gets used to the new hormones.

The light bleeding after sex or spotting usually stops after 3-6 months. If the bleeding after sex continues for longer than that, it’s a good idea to talk to your doctor. They might need to adjust your dose or suggest a different kind of birth control.

Know more: How Soon After Stopping Birth Control Can You Get Pregnant?

Reason #3: Infections

Sometimes, bleeding during sex can be a sign of an infection.

Sexually transmitted infections (STIs) and pelvic inflammatory disease (PID) can cause the cervix and uterus to become inflamed.

When these areas are swollen and irritated, they are more prone to bleeding during vaginal penetration.

Pelvic inflammatory disease (PID) is often caused by untreated STIs that have spread to the uterus, fallopian tubes, and ovaries.

Along with vaginal bleeding, other symptoms of infection might include:

• Itching and irritation around your vagina (the vulvar region)
• Sores or bumps in the vulvar area, or even genital sores
• A vaginal discharge that smells bad
• Bleeding in between your regular periods
• Pain during sex or pelvic pain
• Fever

It’s important to get medical attention for infections. If they aren’t treated, they can lead to more serious problems like:

• Abscesses
• Scar tissue
• Difficulties getting pregnant

Sometimes, common vaginal infections like bacterial vaginosis or yeast infections can also cause irritation that leads to light bleeding. This is especially true after sex.

Reason #4: Polyps on your cervix or uterus

Noncancerous polyps can also cause bleeding after sex.

A polyp is a small growth that can form on the cervix or the inner lining of the uterus. On the cervix, they’re called cervical polyps. And on the inner uterine lining, they’re called endometrial polyps.

These are benign growths, meaning they are not cancerous. Endometrial polyps have been linked to about half of all cases of abnormal uterine bleeding.

They seem to be related to having more estrogen in the body compared to progesterone. Common symptoms of polyps can include:

• Bleeding between periods
• Heavy periods
• Bleeding during or after sex
• Irregular bleeding patterns

Know more: The 8 Types of Abnormal Menstruation You Should Know About

Another condition called cervical ectropion can also cause bleeding. This happens when the glands that usually line the inside of the cervical opening grow on the outer surface of the cervix. This area can be more delicate and prone to bleeding during sex.

Cervical ectropion is usually harmless. It’s often caused by hormonal fluctuations, like when you’re using contraception or during pregnancy.

You might also have:

• Spotting between periods
• More vaginal discharge
• Mild pain

It usually goes away on its own.

Reason #5: Endometriosis

Endometriosis is a condition where tissue similar to the inner lining of the uterus grows outside of it.

This tissue can then become irritated and inflamed during sex, which can lead to bleeding.

Other symptoms of endometriosis are:

• Pelvic pain that gets worse during periods
• Abnormal bleeding (heavy bleeding or
• bleeding between periods)
• Pain during sex
• Pain when using the bathroom
• Fertility problems

Know more: Your Guide to Getting Pregnant With Endometriosis

Reason #6: Changes in the cervix

Sometimes, changes in the cells of the cervix can cause bleeding.

In very rare cases, bleeding after sex can be a sign of cervical cancer. This is why it’s so important to have regular pap smear tests. They check for abnormal cells on the cervix.

Reason #7: Other causes

There are a few other less common reasons for postcoital bleeding

• First-time blood sex: It’s common for people to experience bleeding the first time they have penetrative sex. This is due to the hymen stretching. It’s usually light bleeding and should stop quickly.
• Trauma or injury: Injury to the vagina from accidents or even sexual abuse can cause vaginal bleeding.
• Bleeding from other areas: What looks like vaginal bleeding might actually be something else. It could be blood coming from somewhere else, like hemorrhoids if you’ve had anal sex.