What should you know about heavy bleeding during sex?

Bleeding after penetration can come from delicate or irritated tissue in the vagina or cervix. Around and after menopause, lower oestrogen can make vaginal tissue thinner and drier, so friction may cause small tears and bleeding. Vaginal dryness can also make sex sore.

Other possibilities include a cervical or vaginal polyp, inflammation or infection, a pelvic organ prolapse, or an injury. Abnormal cells in the cervix, vagina, or womb can also cause bleeding during or after sex, so the amount of bleeding cannot identify the cause by itself. Menopause is associated with vaginal changes, but bleeding after periods have stopped still needs checking.

Stop sexual activity if it causes bleeding or pain, and note when the bleeding began, how heavy it was, whether it happened after penetration, and whether you had discharge, fever, dizziness, or pelvic pain. Avoid inserting products into the vagina until you have been assessed.

Book an appointment with a GP, gynaecologist, or sexual health clinician. They may ask about your periods and medicines, examine the vagina and cervix, and arrange tests such as swabs, cervical screening if due, or imaging. If dryness seems involved, a clinician can discuss lubricants and treatment options suited to you.

Seek urgent medical help if bleeding is heavy or ongoing, you feel faint or weak, you have severe or worsening pelvic or abdominal pain, or you develop fever or feel very unwell. Get prompt advice for any bleeding after menopause, even if it happens only once, and for bleeding after sex that keeps returning.

Ask what areas may be bleeding, whether you need an examination or tests, and whether medicines, dryness, infection, or a prolapse could be contributing. Tell them if your periods have stopped, if you take blood-thinning medicine, or if you have pain, unusual discharge, or bleeding between periods.