What should you know about bleeding after sex?

Bleeding after sex may come from irritation or a small tear, especially when there is not enough lubrication. Changes linked with menopause can make vaginal tissue drier and more fragile. Bleeding can also occur with inflammation or infection, including chlamydia, or with changes on the cervix such as cervical dysplasia.

Bleeding after sex is a presentation of cervical cancer in some people, but the symptom alone cannot identify its cause. Vaginal cancer is another uncommon possibility. A clinician may ask about timing, amount, pain, discharge, contraception, pregnancy possibility and screening history before deciding whether an examination or tests are needed.

Arrange a medical assessment if the bleeding happens again, occurs outside your expected period, follows menopause, or has no clear explanation. Until you are assessed, note when it happens and whether you have pain, discharge, fever or bleeding between periods. Avoid sex if it causes pain or heavier bleeding, and do not use leftover antibiotics.

Depending on the findings, assessment may include a pregnancy test, infection testing, a pelvic examination or cervical screening. A cone biopsy is a specific procedure used only when a clinician needs to examine or remove an area of abnormal cervical tissue.

Seek urgent care for heavy bleeding, severe pelvic or abdominal pain, faintness, shoulder-tip pain, fever with feeling very unwell, or bleeding during a possible pregnancy. These warning signs need prompt assessment rather than waiting for a routine appointment.

Could dryness, irritation or an infection explain this bleeding? Do I need testing for chlamydia or another infection? Is my cervical screening up to date? What examination or follow-up is appropriate if the bleeding returns?