It's generally known that women can bleed after having sex for the first time, but more than 9% of women experience post-sex spotting for various reasons that don't involve losing your virginity. Spotting after sex is technically known as "postcoital bleeding," and although a designated medical term and the bleeding itself may seem alarming, there are a number of reasons you may be experiencing spotting after sex.
We talked to Neeraj Kohli, MD, a urogynecologist and the co-founder of UberDoc, an app that connects patients with specialists, for his insight on spotting after sex. "First thing, don't panic. Refrain from any further sexual activity." There are many causes that are normal and temporary (though some do require immediate medical attention). Below, take a look at a list of reasons you might be spotting after sex to ease your mind or give you the needed push to call your doctor for a consult.
Also known as genitourinary syndrome of menopause, or GSM, vaginal atrophy is common in women who are going through or are close to going through menopause or have removed their ovaries. When a woman enters menopause, her body produces less estrogen, and when your estrogen levels are lower, your body produces less lubrication during sex. Your vaginal tissues can also shrink and become thinner. When you are experiencing vaginal atrophy, sex can cause your vagina to become inflamed and dry, which leads to pain, discomfort, and, you guessed it, bleeding.
Although it might sound scary, cervical ectropion is not a disease, nor does it affect fertility or prove to be cancerous. Cervical ectropion, in simple terms, is when the soft cells of your cervical canal spread to the outside of the cervix, where the hard cells are usually located. The reason for bleeding after intercourse is the softer cells, known as glandular cells, aren't as strong as the others and tend to produce mucus faster and bleed easier.
During sex or particularly rough sex, your vagina can form cuts and tears that lead to bleeding. You are more likely to experience this cause of spotting after sex if you are also experiencing vaginal dryness.
Vaginitis, sometimes referred to as vulvitis or vulvovaginitis, is an infection and inflammation of the vulva and the vagina that affects up to 30% of women of childbearing age. One of the main symptoms of vaginitis is the irritation, itching, and dryness of the vulva and the vagina. If you have sex with vaginitis, there is a high chance that the dryness will irritate your vagina and cause a tear, leading to spotting after sex.
A polyp is a growth that is noncancerous but causes discomfort, commonly found in the cervix or the lining of the uterus. Polyps dangle, and when they move it causes irritation, which leads to bleeding. Sex can promote movement with a polyp and therefore lead to spotting after sex.
"It is important to find the cause of bleeding before implementing a plan to prevent it," Kohli explains. "If it's related to injury or trauma, preventative measures can include lubrication during intercourse, different positions, and trying to dilate or stretch the vagina in between sexual activity." Being in control during sex can help to prevent bleeding, as can lying on your back.
You can get a feel for where there is a pain when you're in control and change it immediately, and lying on your back can help to prevent disturbing polyps or the cervix. Dilation, or stretching, of the vagina, happens naturally when women get turned on and have sex, a result of natural lubrication and the relaxation of the vaginal muscles. Dilating the vagina before sex can help to make sex easier and more comfortable, especially if natural lubrication and stretching may not be an option.
"Sometimes pressure and an ice pack can help," Kohli explains. "Usually, spotting is self-limited," so you can treat it yourself if you aren't in pain or experiencing bleeding frequently after sex. If the bleeding is persistent or you're experiencing pain, a trip to the gynecologist might be necessary. They might suggest estrogen therapy, which can help with lower estrogen production caused by menopause, or antibiotics, which can target infections such as vaginitis."
Kohli reminds us that if you have persistent spotting beyond 24 hours or it develops into heavy vaginal bleeding, consult your doctor.