Internal bleeding from sex

Friction, dryness, a small vaginal or cervical tear, or inflammation can cause blood after penetration. Cervical ectropion, polyps, hormonal changes, and infections such as [Chlamydia](/conditions/chlamydia/) may also lead to bleeding. After menopause, thinner vaginal tissues associated with [Genitourinary Syndrome of Menopause](/conditions/genitourinary-syndrome-of-menopause/) can make contact bleeding more likely. Less commonly, changes of the cervix or vagina, including [Cervical Dysplasia](/conditions/cervical-dysplasia/), [Cervical Cancer](/conditions/cervical-cancer/), or [Vaginal Cancer](/conditions/vaginal-cancer/), can present with bleeding. A symptom does not identify its cause by itself.

Pause penetrative sex until bleeding and discomfort have settled, and use a pad to observe the amount. Arrange a gynaecology or primary-care appointment if bleeding recurs, happens after menopause, follows a new sexual partner, or comes with discharge, pelvic pain, or pain during sex. The clinician may examine the vagina and cervix, offer infection testing, and check whether cervical screening is due. If a cervical sample needs further assessment, a [Cone Biopsy](/treatments/gynaecological-surgery/cone-biopsy/) may be discussed only when clinically appropriate.

Seek emergency care for bleeding that is heavy or rapidly worsening, severe pelvic or abdominal pain, fainting, dizziness, weakness, fever, or a swollen abdomen. Go urgently as well if pregnancy is possible and bleeding is accompanied by pain or light-headedness. A small smear after sex can still warrant a routine appointment if it repeats; urgency depends on the amount, associated symptoms, and your overall condition.

Could dryness, a tear, infection, or a cervical change explain this bleeding? Do I need an examination or infection tests? Is my cervical screening current? Should I avoid sex until the cause is clear?