Abnormal vaginal bleeding after sex

The blood may come from the vulva, vagina, cervix, or uterus. Its amount or colour cannot reliably locate the source, and absence of pain does not remove the need for a check.

Friction can irritate tissue when lubrication is limited. Genitourinary syndrome of menopause can make vaginal and vulval tissue thinner, drier, and easier to injure. A cervical ectropion or polyp may also bleed on contact.

Chlamydia can present with bleeding after sex, sometimes with discharge, pelvic discomfort, or pain during sex. Cervical dysplasia and cervical cancer can present with postcoital bleeding. Vaginal cancer may present with vaginal bleeding or blood-stained discharge, but these symptoms do not establish a diagnosis.

Note whether bleeding follows every episode of sex or occurred once, how much blood you saw, where you are in your cycle, and whether there is pain, dryness, discharge, or urinary discomfort. Take a pregnancy test if pregnancy is possible and avoid sex if it causes pain or renewed bleeding until assessed.

A clinician may ask about contraception, partners, medicines, menopause symptoms, and cervical screening. Testing can include an examination with a speculum, infection samples, a pregnancy test, and closer examination of the cervix when indicated. Treatment is matched to the identified cause.

Seek urgent help if bleeding is heavy, you feel faint or very dizzy, or you have severe abdominal or pelvic pain. Bleeding with pain after a missed period needs urgent pregnancy assessment because an ectopic pregnancy must be ruled out.

Obtain prompt advice for fever, worsening pelvic pain, offensive discharge, or bleeding after menopause. Otherwise, book a clinical or sexual-health appointment even if the bleeding has stopped, particularly when it recurs.

Ask where the bleeding appears to originate, whether infection tests or cervical examination are needed, and whether cervical screening is up to date. If dryness is present, ask about suitable moisturisers, lubricants, or prescribed treatment and when sexual activity can be resumed comfortably.