What should you know about continued bleeding after sex?

Postcoital bleeding may appear as spotting or flow after penetrative sex. Friction, dryness, a small tear, cervical ectropion, polyps, or inflammation can be responsible. Chlamydia can irritate the cervix and may occur with discharge, pelvic pain, or pain during sex.

Genitourinary syndrome of menopause can make vaginal and urinary tissues thinner and drier, which may lead to bleeding with contact. Cervical dysplasia, cervical cancer, and vaginal cancer can also present with bleeding after sex. Bleeding does not establish any one diagnosis, but repeated episodes should not be ignored.

Arrange a gynaecology review. Note when bleeding occurs, its amount and colour, whether it follows every episode, and any pain, discharge, dryness, or pregnancy possibility. A clinician may examine the vagina and cervix and recommend infection testing, cervical screening, or imaging.

Avoid sex that causes pain or bleeding until you have advice, and do not douche. Treatment depends on the finding; a cone biopsy may be discussed only when cervical tissue needs closer examination or removal.

Seek urgent care for heavy bleeding, severe lower-abdominal pain, faintness, shoulder-tip pain, or possible pregnancy. Get prompt review for fever, foul-smelling discharge, rapidly increasing pain, or bleeding after menopause.

Ask whether the cervix or vaginal tissue looks irritated, whether infection testing or cervical screening is due, and whether dryness could be contributing. Ask what findings would require a biopsy, how results will be communicated, and what symptoms should trigger faster help.