Ask an Expert: Minor bleeding during/post intercourse

Women's Health

Minor bleeding during/post intercourse
02/07/2006

Question:

I have minimal bleeding during sex: like you only know I`m bleeding when they pull out and the lights are on. It`s bright red, and I never have any type of discomfort, there may be slight pink after urinating for the next day or so.
But other than `gassy` there is nothing uncomfortable about the experience except that it happens almost every time. My PAPs have always been normal the last one was a little over a month ago. I only am active maybe 2-4 times a month. I am on birth control pills, and it happens no matter what point in my cycle. Without any signs of discomfort, discharge, itching, etc.
It is awkward when my partner become more concerned with me than what we are doing. (I suppose their concern means I`ve picked admirable men, but that`s not the point.) Any advice would be so very welcomed.

Answer:

Bleeding during intercourse can be a symptom of many common problems. I urge you to seek medical care to evaluate for any problems.

Bleeding during intercourse can be caused by many structural problems. A commonly seen thing is a cervical polyp. This is a small growth which is non-cancerous that pokes through the opening of the cervix and bleeds when it is touched in any way. Your doctor would be able to look for this or other less common growths or lesions during a pelvic exam.

Another common problem is cervical cancer or precancerous cells which can cause abnormal bleeding during intercourse. You state that your PAP tests have always been normal. This is reassuring if you are getting screened for cervical cancer as often as you should. Women who are sexually active and in their 20's should be screened every year.

Trauma is another cause of bleeding during intercourse. Most women who are having bleeding from trauma report some pain or at least some discomfort during sex. The most common source of trauma is around the opening of the vagina, but could occur at other locations within the vagina.

Infections have not been shown to be a major source of bleeding during intercourse, but you should be tested for the usual problems which include gonorrhea, chlamydia and HPV (human papilloma virus), which causes warts.

I hope that this helps you to ask better questions at your doctor's office and that the problem resolves soon. As always, please keep yourself safe from sexually transmitted diseases by using condoms with every act of intercourse, limit the number of partners you have, and make sure you and any new partner get screened for sexually transmitted diseases prior to having protected intercourse.

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Response by:

Allison A Macerollo, MD
Clinical Assistant Professor
Associate Director of Physician Development
Department of Family Medicine
College of Medicine
The Ohio State University