A lot of bleeding after sex

Stop sexual activity, use a pad rather than an internal product so you can observe the bleeding, and contact an urgent care service. Heavy blood loss cannot be safely attributed to friction without an examination.

Bleeding can arise from a vaginal tear, dry or inflamed tissue, the cervix, or the uterus. Infection, a cervical polyp, and changes in the cervix are among the possibilities. Cervical dysplasia, cervical cancer, and vaginal cancer may present with bleeding after sex, but the symptom alone does not establish any diagnosis.

The clinician will want to distinguish contact bleeding from a period or bleeding related to pregnancy. Pain, discharge, fever, pregnancy possibility, recent procedures, medicines that affect clotting, and bleeding elsewhere all help guide the assessment.

Note when the bleeding began, whether it is slowing, and any clots, pain, dizziness, discharge, or injury. Do not insert tampons, menstrual cups, medicines, or washes into the vagina, and do not resume penetration until you have been assessed and the bleeding has settled.

At the visit, examination may identify a tear or a source on the cervix. Depending on the history, the clinician may also offer a pregnancy test, blood tests, infection testing, or imaging. A cervical screening history is useful, but screening is not a substitute for investigating active bleeding.

Go to emergency care now if the bleeding is rapid or ongoing, you are passing large clots, or you develop fainting, confusion, breathlessness, chest discomfort, severe abdominal or pelvic pain, cold clammy skin, or marked weakness. Do not drive yourself if you feel faint. Possible or confirmed pregnancy with heavy bleeding also requires urgent assessment, particularly when pain is one-sided or reaches the shoulder tip.

Ask where the bleeding appeared to originate, whether follow-up examination or imaging is needed, and when sexual activity can safely resume. Clarify whether you need infection testing, treatment for vaginal dryness, review of medicines, or a separate appointment to assess the cervix.