What should you know about extreme bleeding after sex?

Bleeding after sex can come from a small tear, dryness, inflammation, infection, or changes on the cervix. Chlamydia and Genitourinary Syndrome of Menopause are examples of conditions that may affect genital tissues. Cervical Dysplasia, Cervical Cancer, or Vaginal Cancer can also present with bleeding after sex, but the symptom cannot identify which cause applies. A clinician may ask about timing, amount, pain, discharge, contraception, pregnancy possibility, and screening history before deciding on examination or tests.

Pause sex and use a pad so you can observe the amount of bleeding; avoid inserting anything into the vagina until you have advice. Arrange prompt review with a gynaecology or sexual health clinician, particularly if this has happened more than once. Do not douche or use unprescribed vaginal products. Note whether bleeding started during or after penetration, how long it lasted, and whether pain, discharge, fever, or urinary symptoms occurred. Bring a list of medicines and tell the clinician if pregnancy is possible.

Seek emergency care for bleeding that is rapidly soaking pads, severe or one-sided pelvic pain, dizziness, fainting, shoulder-tip pain, fever with feeling very unwell, or possible pregnancy. Call emergency services if you are collapsing or cannot stay awake. Urgency is based on the amount of bleeding and associated symptoms, not on assuming that the symptom has a particular cause.

Ask whether you need a pregnancy test, infection testing, cervical examination, or imaging, and when results will be available. Ask how to protect the area while it heals and when sex can safely resume. If a cervical change is found, ask whether a Cone Biopsy is relevant and why.