Ask a GP: Is it OK to bleed after sex?

YOU don't have your period and yet, after having sex, you're bleeding from down below.

The question is: Should you just ignore it, or is bleeding after sex (also known as postcoital bleeding) something to worry about?

"Postcoital bleeding should never be considered normal," says Obstetrician and Gynaecologist Dr Joseph Sgroi. But that doesn't mean you need to panic, either.

"While bleeding might be distressing and may cause worry, in the majority of cases the cause is relatively benign," he reassures.

So why do some women bleed after sex?

There are actually quite a few possible reasons, explains Dr Sgroi. He says it could be due to abnormalities or infections of the uterus, cervix or vagina. Or, it could happen as a result of a cut, scrape or tear of the vagina - which can happen if things are a little "rough" or "vigorous" between the sheets.

Those kinds of injuries are more likely to occur if you have vaginal dryness, or if you're breastfeeding. (They're also more common in postmenopausal women.)

You could also bleed after sex if you have a sexually transmitted infection (STI). Other symptoms of an STI include a change in your discharge, pain during sex, itchiness or irritation of the genitals and sores or lesions in that area.

If you think you might have an STI, see your GP for a proper diagnosis and treatment. Abstain from sex until you've been seen, and make sure your sexual partners also get checked.

Endometriosis can also cause bleeding after sex

Other symptoms of endometriosis include severe pain or bleeding during your period, pain during bowel movements or urinating (especially when you have your period) and painful sex.

If you think you may have endometriosis, see your doctor, as there are ways to help manage your condition.

For women who bleed after sex, one big worry may spring to mind: Is this a sign of cancer?

"Cancer is, in fact, one of the less likely causes" of vaginal bleeding after sex, says Dr Sgroi.

A review from 2006 looked into that issue. For the review, the authors looked at over 900 articles and found that, at any one time, around 0.7 to 9 per cent of women bleed after sex. Of those women, only one in 44,000 of those aged between 20-24 years old had cervical cancer. (That number increased to one in 2,400 for those aged 45-54 years). In other words, if you bleed after having sex, it is unlikely to be a sign of cervical cancer, especially if you're young.

So, while it's not uncommon to bleed after you've had sex, this is one of those issues that should have you booking an appointment with your GP to get things checked out. And yes, that's still the case if you think you bled because things were a little rougher than normal, says Dr Sgroi.

"Even if it occurs as a result of an accidental trauma - regardless of the timing concerning sex, or amount of bleeding - it is best to seek medical advice, if only to find ways to avoid such injuries in the future."

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