Pain and bleeding after sex

Small surface tears or irritated vaginal tissue can cause soreness and a little blood, particularly when lubrication is low. Genitourinary syndrome of menopause can make tissue thinner, drier, and more prone to bleeding. Cervical dysplasia or cervical cancer can present with bleeding after sex, although bleeding has many other possible explanations. Vaginal cancer is uncommon but may also need consideration when bleeding is persistent or accompanied by a lump or unusual discharge. Chlamydia and other infections can cause bleeding, pelvic pain, discharge, or burning when urinating.

The amount, colour, timing, and recurrence matter. Bleeding from the vagina, cervix, or a small external injury can look similar, so an examination is needed when the symptom is new, recurrent, or unexplained.

Pause penetration until bleeding and pain settle, and avoid products that cause stinging. Note when bleeding starts, how long it lasts, whether it follows deep penetration, and whether you have discharge, fever, urinary symptoms, or bleeding between periods. Arrange a gynaecological review; testing may include an examination, infection testing, cervical screening or imaging depending on your history. Do not self-treat a possible infection with leftover medicine.

Seek urgent help for heavy or ongoing bleeding, severe pelvic pain, faintness, fever, or a positive pregnancy test with pain or bleeding. Prompt review is appropriate for bleeding that keeps recurring, occurs after menopause, or comes with unusual discharge or a pelvic mass.

Where might the blood be coming from? Do I need infection testing or a cervical examination? Is my cervical screening up to date, and would a cone biopsy ever be considered based on an abnormal result?