What should you know about mid-cycle bleeding after sex?

The cervix can bleed when it is inflamed, infected or more delicate than usual. Chlamydia and other infections may cause bleeding after sex, pelvic discomfort, discharge or pain when passing urine. Genitourinary syndrome of menopause can make vaginal tissue thinner and drier, even when periods have already changed or stopped.

Less common causes include cervical dysplasia, cervical cancer or vaginal cancer. Bleeding after sex is a presentation of these conditions, not proof that someone has them. A clinician may examine the vagina and cervix, offer infection testing and check whether cervical screening is due.

Record when the bleeding occurs, its amount and colour, whether sex was painful, and any discharge, pelvic pain or pregnancy possibility. Avoid vaginal products that sting, and consider lubrication if dryness may be contributing. Arrange a GP or gynaecology appointment when bleeding repeats or has no clear explanation.

Be open about contraception, new partners, menopause symptoms, cervical screening and medicines. Testing and examination are confidential, and a partner may also need sexual-health advice if an infection is found.

Seek urgent care for heavy bleeding, faintness, severe or one-sided pelvic pain, fever, shoulder-tip pain, or bleeding with a possible pregnancy. Emergency assessment is needed if you feel weak, clammy or short of breath. Do not wait for a routine appointment if symptoms are rapidly worsening.

Could the bleeding be from the cervix, vagina or an infection? Do I need a pregnancy test or sexual-health tests? Is my cervical screening up to date? What would make a colposcopy, biopsy or treatment such as a cone biopsy appropriate?