Heavy bleeding after rough sex

Friction or deeper penetration can cause small tears in the vaginal wall or irritation around the cervix. Dryness can increase tissue vulnerability, including with Genitourinary Syndrome of Menopause. Bleeding after sex can also occur with inflammation or infection such as Chlamydia, cervical dysplasia, or less commonly cancer of the cervix or vagina. The presence of bleeding does not establish any one diagnosis.

A clinician may ask about consent and safety, pain, dryness, contraception, pregnancy possibility, discharge, and whether bleeding occurs at other times. They may examine the vagina and cervix and arrange swabs or other tests based on your history.

Stop sexual activity until bleeding has stopped and any pain or injury has been assessed. Use a pad to observe the flow, and avoid tampons or vaginal products. Arrange prompt medical care if bleeding is heavy, continues, happens again, or is accompanied by discharge or pelvic pain. If a cervical abnormality needs investigation, a procedure such as Cone Biopsy may be discussed by a specialist.

Seek emergency help for bleeding that rapidly soaks pads, faintness, severe or worsening pelvic pain, weakness, breathlessness, a racing heartbeat, or cold clammy skin. Get prompt assessment for fever, offensive discharge, pain after an injury, or bleeding after sex that keeps recurring. If the sex was not consensual, move to a safe place and seek urgent medical and safeguarding support.

Ask: Could there be a tear, dryness, infection, or cervical cause? Do I need an examination, infection tests, or cervical screening? When is it safe to have sex again? What lubrication or treatment could reduce tissue irritation? What symptoms should send me to emergency care?