Vaginal bleeding during sexual contacts – it can feel scary and sometimes embarrassing for some women to notice, especially when they have no idea why it’s happening to them.

Although many women will notice small amounts of blood after sexual intercourse (this is often more easily noticed when one pees after sex or, the next day, in noticing small amounts of blood on one’s underwear), it is less common to notice more moderate or larger amounts of blood loss during intimacy.

Vaginal bleeding after sexual contacts – causes

First Time

Not every girl bleeds the first time. The reason why some girls bleed the first time they have intimate contact is because the hymen, a very thin piece of skinlike tissue that stretches partly across the opening of the vagina, breaks or tears. Some girls are born without much of a hymen, while some girls’ hymens cover a large portion of the vagina’s opening.
Whether a girl bleeds also partly depends on whether the hymen is broken or torn before. This may occur from vigorous physical activity; tampon insertion; and masturbation and fingering.

Pregnancy

Many women have vaginal spotting or bleeding in the first 12 weeks of pregnancy. Bleeding of the cervix may occur during sexual contacts.

Cervical dysplasia

Cervical dysplasia is precancerous changes of the epithelial cells that line the cervix. Risk increases with multiple sexual partners, sexual activities before age 18, childbirth before age 16, or a past history of STDs.

Vaginal tears

Small amounts of bleeding noticed after intercourse may be caused by small vaginal tears (sometimes called “micro-tears”) in the vaginal wall or even on the vulva (the outside parts of a woman’s genitals). These often heal within 1-3 days after sexual contact and may more easily heal if you try not to further aggravate these tears with more sexual activities, masturbation, tampon use or other types of vaginal penetration (such as fingering).

Inflammations and/or irritations

Endometritis is the inflammation of the endometrium (the innermost layer of the uterus) – associated with infections.
Vaginitis or Cervicitis – inflammation or swelling and infection of the vagina or cervix.

Adenomyosis

Adenomyosis is when endometrial tissue attaches itself to the uterus, or another organ such as the ovaries, and grows outside of the uterus.

Sexually Transmitted Infections (STIs)

Bleeding during or after sexual contacts can also be a sign of a sexually transmissible infection (STI) that may have caused irritation to or inflammation of a woman’s reproductive organs, such as her cervix and uterus. Often, however, STI-related bleeding also shows up as vaginal bleeding or discharge even on days when a woman is not having any sexual contacts at all.
Chlamydia – the bacterial infection that is usually transmitted through sexual activity or contact with semen, vaginal fluid, or blood.
Gonorrhea – common sexually transmitted disease caused by bacteria. Several pharmaceutical treatments are available.
Trichomoniasis – common sexually transmitted disease caused by protozoan. Can also be passed to newborns during vaginal birth by infected mothers.

Vaginal Yeast Infection

An overgrowth of the normal fungi that inhabits the vaginal area. Common symptoms include itching, burning, and an odorless, white, cheese-like discharge.

Cervical polyps

Cervical polyps can bleed when touched during intimacy. Cervical polyps are smooth, red or purple, finger-like growths that grow out of the mucus layer of the cervix or the cervical canal. Cervical polyps are extremely fragile, extending out of the cervix, and easily and painlessly removed.

Uterine polyps

Uterine polyps occur when the endometrium overgrows causing these protrusions into the uterus. Women with uterine polyps frequently experience bleeding between periods, vaginal bleeding after sex, spotting and bleeding after menopause.

Fibroid tumors

Uterine fibroid tumors are usually benign tumors. It’s important that women with fibroids make sure they never take estrogen, in any form including birth control pills, since estrogen increases fibroid growth.

Trauma

Sometimes exuberant or rough sexual activities can cause occasional bleeding during and/or after intimate contacts.

Drugs

Aspirin, blood-thinning drugs or birth control pills may also cause post-sex bleeding. Sometimes low-dose birth control pills may cause hypoplasia (too-thin uterine lining) which in turn may cause bleeding after sexual contacts. Missing a pill or taking one late may also trigger this bleeding.

Blood in semen

In some cases, a woman may notice blood coming from her vagina after sexual contact and think it’s her own blood, only to find that her partner had blood in his semen that he then ejaculated into her vagina, and as it came out (thanks to gravity) it seemed like it was vaginal bleeding.

In most cases it is better to visit your doctor and discover the cause of bleeding during and/or after sexual activities.