Bleeding after sex when you are not pregnant

One light episode may follow surface irritation, but repeated, unexplained, or postmenopausal bleeding needs a medical examination to locate the source.

Blood may arise from a small vaginal abrasion or tissue made fragile by dryness. Genitourinary syndrome of menopause can cause dryness, burning, urinary symptoms, and contact bleeding. On the cervix, inflammation from chlamydia or another infection, a benign polyp, or delicate surface cells may bleed when touched.

Cervical dysplasia may cause no symptoms, while cervical cancer and vaginal cancer can present with bleeding after sex. Postcoital bleeding does not show that cancer is present; its persistence is the reason to examine the vagina and cervix and complete appropriate tests.

Keep a brief record of the amount and colour of blood, whether it follows every sexual encounter, the menstrual-cycle timing, and any dryness, discharge, urinary symptoms, pelvic discomfort, or pain during sex. Include new partners, condom use, contraception, medicines, menopause status, and your most recent cervical screening.

Arrange a clinic visit if the cause is unclear or bleeding returns. The clinician may inspect the vulva, vagina, and cervix; offer infection testing; and recommend cervical screening or further investigation according to what is found. Gentle activity and a suitable lubricant can reduce friction while you wait, but stop penetration if bleeding or discomfort recurs.

Seek emergency help for heavy bleeding, fainting, severe dizziness, breathing difficulty, or severe abdominal or pelvic pain. If pregnancy was excluded only by an early home test and these symptoms occur, urgent assessment is still needed.

Contact a clinician promptly when there is fever, foul-smelling discharge, worsening pelvic pain, bleeding after menopause, or possible exposure to a sexually transmitted infection. Repeated painless spotting should be booked for assessment rather than watched indefinitely.

Ask whether the blood appears to come from the vagina or cervix, whether infection testing is needed, and whether cervical screening is current. If abnormal cells are found, ask what additional examination is recommended and what a procedure such as cone biopsy would be used to clarify or treat.