What causes vaginal bleeding after sex?

Possible explanations include a small vaginal tear, cervical ectropion, a cervical polyp, chlamydia or another infection, and thinning or dryness linked to menopause. Cervical or vaginal cancer can present with bleeding after sex, but bleeding has many non-cancerous causes and the symptom alone cannot identify the cause.

Friction can disturb delicate vaginal tissue, especially when lubrication is limited. Hormonal change around or after menopause may make the vaginal lining thinner and easier to injure. The cervix may bleed when soft glandular cells sit on its outer surface, when a polyp is touched, or when infection causes inflammation.

A clinician will ask whether bleeding happens every time, how much there is, and whether discharge, pelvic pain or pain during sex occurs. Assessment may include a pregnancy test, infection testing and an examination of the vagina and cervix. Cervical screening is not designed to diagnose a current bleeding episode, so symptoms still need evaluation even if screening is up to date.

Book a medical or sexual health appointment for bleeding after sex, particularly if it recurs. Note when it happens in relation to your period, its colour and amount, contraception, medicines, menopausal status, pregnancy possibility and any discharge or discomfort. An infection can be treated, while dryness may improve with a suitable lubricant, vaginal moisturiser or clinician-recommended hormonal treatment.

Further investigation depends on the examination. A clinician may arrange colposcopy, ultrasound or another test if the cervix looks unusual or the source remains unclear. A cone biopsy is used only in selected situations involving abnormal cervical cells; it is not a routine treatment for bleeding itself.

Seek urgent help if bleeding is heavy, you feel faint or weak, or you have severe pelvic or abdominal pain. A missed period or possible pregnancy together with bleeding and pelvic pain needs prompt assessment because an ectopic pregnancy must be excluded. Fever, offensive discharge or rapidly worsening pain also warrants urgent review. Any bleeding after menopause should be checked without delay through the appropriate local service.

Ask whether the bleeding appears to come from the vagina or cervix, which infections are being tested for, and whether the examination found dryness, ectropion or a polyp. Clarify when results will arrive, whether to pause penetrative sex while tissue heals, and what further test is planned if bleeding returns.