Postcoital Bleeding: Clinical Reasons for Bleeding After Intercourse

Bleeding after sex (also called postcoital bleeding) can be surprising and concerning. While it is often caused by minor or treatable issues, it can sometimes signal a medical condition that needs attention. This article explains the most common clinical reasons for bleeding after intercourse, what symptoms to watch for, and when it's important to speak to a doctor.

The goal here is clarity—not fear. Most causes are not life-threatening, but none should be ignored without thought.

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What Is Postcoital Bleeding?

Postcoital bleeding means vaginal bleeding that happens during or after sexual intercourse and is not related to a menstrual period. It can range from light spotting to heavier bleeding.

It may occur:

• Once and never return
• Occasionally
• Repeatedly after sex

Any pattern of ongoing or unexplained bleeding after sex deserves medical evaluation.

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Common and Treatable Causes of Bleeding After Sex

1. Cervical Irritation or Inflammation (Cervicitis)

The cervix is sensitive and can bleed easily when inflamed.

Common triggers include:

• Bacterial or viral infections
• Sexually transmitted infections (STIs)
• Allergic reactions to condoms, lubricants, or spermicides

Symptoms may include:

• Light bleeding after sex
• Unusual vaginal discharge
• Pelvic discomfort

Treatment usually involves medication once the cause is identified.

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2. Cervical Polyps

Cervical polyps are small, noncancerous growths on the cervix. They are a frequent cause of bleeding after sex.

Key points:

• Often harmless
• Can bleed when touched during intercourse
• More common in people who have given birth or are over 30

Removal is typically simple and may completely resolve the bleeding.

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3. Vaginal Dryness or Thinning (Vaginal Atrophy)

Low estrogen levels can cause the vaginal tissue to become thin, dry, and fragile.

This is common in:

• Menopause
• Breastfeeding
• Certain hormonal treatments
• After ovary removal

Signs include:

• Pain during sex
• Burning or itching
• Light bleeding after sex

Lubricants, moisturizers, or hormone-based treatments may help.

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4. Minor Vaginal Tears or Trauma

Friction during intercourse can sometimes cause small tears, especially if:

• There is insufficient lubrication
• Sex is vigorous
• Vaginal tissue is already fragile

These usually heal on their own, but repeated injury should be assessed by a clinician.

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Infections That Can Cause Bleeding After Sex

5. Sexually Transmitted Infections (STIs)

Several STIs can cause inflammation and bleeding, including:

• Chlamydia
• Gonorrhea
• Trichomoniasis
• Herpes (if sores are present)

Possible symptoms:

• Bleeding after sex
• Painful urination
• Pelvic pain
• Abnormal discharge

Early diagnosis and treatment are important to prevent complications.

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6. Pelvic Inflammatory Disease (PID)

PID is an infection of the reproductive organs, often linked to untreated STIs.

It may cause:

• Bleeding after sex
• Lower abdominal pain
• Fever
• Pain during intercourse

PID requires prompt medical treatment to reduce the risk of long-term issues.

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Structural and Hormonal Causes

7. Endometriosis

Endometriosis occurs when tissue similar to the uterine lining grows outside the uterus.

It may cause:

• Painful sex
• Spotting or bleeding after sex
• Chronic pelvic pain

Diagnosis can take time, but treatment options are available.

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8. Hormonal Imbalances

Hormone fluctuations can make the uterine lining unstable.

This may be linked to:

• Birth control changes
• Missed pills
• Irregular ovulation

Bleeding after sex may be one of several cycle-related symptoms.

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More Serious (But Less Common) Causes

9. Cervical, Vaginal, or Uterine Cancer

Cancer is not the most common cause of bleeding after sex, but it must be ruled out—especially if bleeding is:

• Persistent
• Worsening
• Accompanied by pelvic pain or unexplained weight loss

Regular cervical screening significantly reduces risk. Early detection makes treatment more effective.

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Emotional and Sexual Trauma Considerations

Bleeding after sex can sometimes be associated with past or ongoing harm, including non-consensual experiences, painful or distressing intercourse, or psychological stress that affects physical responses. If you're experiencing symptoms that may be connected to Sexual Trauma, Ubie's free AI-powered symptom checker can help you understand what you're experiencing and guide you toward appropriate support and care.

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When Should You Speak to a Doctor?

You should speak to a doctor if you experience:

• Bleeding after sex more than once
• Heavy bleeding
• Bleeding with pain, fever, or discharge
• Bleeding after menopause
• Any bleeding that feels unusual or worrying

Seek urgent medical care if bleeding is heavy, sudden, or accompanied by severe pain or dizziness.

A healthcare provider may recommend:

• Pelvic exam
• Cervical screening
• STI testing
• Ultrasound or blood tests

These evaluations are routine and aimed at keeping you safe.

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What You Can Do Right Now

While waiting to see a doctor:

• Avoid intercourse if bleeding is ongoing
• Use gentle, water-based lubricants
• Track when bleeding occurs and any other symptoms
• Avoid douching or harsh vaginal products

Do not self-diagnose or delay care if symptoms persist.

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Key Takeaways

• Bleeding after sex is common and often treatable
• Most causes are not serious, but some require medical attention
• Infections, cervical changes, dryness, and minor trauma are frequent reasons
• Persistent or postmenopausal bleeding should always be evaluated
• Emotional and sexual health matter just as much as physical health

If something feels wrong, trust that instinct and speak to a doctor. Early evaluation can provide reassurance, treatment, and peace of mind.

Your body is communicating with you—listening is an important step toward staying well.