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Expert Q&A

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What would cause bleeding during sex?

Asked by Tisha, Indianapolish

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I've noticed some bleeding during sex lately. All my Pap results and STD tests came back normal. What could be causing the bleeding and what should I do next?

Expert Bio Picture

Living Well Expert Dr. Jennifer Shu Pediatrician,
Children's Medical Group

Expert answer

Thanks for your question. I'm glad that you got checked out and that your tests were normal. Bleeding during or after sex is a relatively common occurrence that can have many causes, most of which are not serious or dangerous. There are some instances when medical treatment is necessary, however, so further evaluation would be helpful if this bleeding continues. To better help you, I consulted Dr. Gary Glasser of Atlanta Gynecology and Obstetrics in Decatur, Georgia. Dr Glasser shares the following information:

Bleeding after sexual intercourse (also called "post-coital bleeding") is not rare; up to 10% of women have had this at some point in their lives. Abnormal bleeding can bring up the thought, "Is this cancer?" Fortunately, the risk of cancer with post-coital bleeding is not common (thousands of women will have this type of bleeding for every one cancer found).

Should a woman have an episode of post-coital bleeding, she should see her health care professional. The vagina may be the source of the blood, as small tears from intercourse may occur at any age (but more commonly after menopause due to the loss of elasticity or "vaginal dryness" as it is commonly known). The cervix may have a benign (not life-threatening) condition where the cells usually found on the inside the cervical canal are on the outside of the cervix. These cells are sensitive to touch (such as during a Pap smear or intercourse) and may bleed. Any vaginal discharge should be cultured and looked at under a microscope, since infections such as chlamydia can cause bleeding if they affecting the cervix. Also, benign cervical polyps (they look like little skin tags on the cervix) can easily and painlessly be removed in an office setting.

A Pap smear should be done if the woman is due for one (depending on her age and previous Pap smear history) and any lesions on the cervix (or the vagina) should be biopsied to evaluate for pre-cancer or cancer of the cervix.

In the majority of cases, however, no cause is found for the post-coital bleeding. If the bleeding persists or there is bleeding other than post-coital, a further evaluation of the cervical canal and/or uterus should be done by a gynecologist.

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