Pain during sex with bleeding afterward: what to know

Friction, inadequate lubrication or a small surface tear can cause soreness and light bleeding. Infection or inflammation involving the vagina, cervix or pelvis may cause pain, discharge or bleeding. Deep pain can occur with endometriosis or an ovarian endometrioma. Lichen sclerosus, vulvodynia and genitourinary syndrome of menopause can make tissue fragile or sensitive. Bleeding after sex is a symptom to investigate, not proof of any one condition.

Pause penetration until bleeding and pain have settled. Note the amount and colour of blood, whether it follows every episode, and any discharge, odour, itching, urinary discomfort or pelvic pain. Use lubrication when you resume and avoid scented products that irritate the vulva. Book a clinician review for unexplained, recurrent or postmenopausal bleeding; assessment may include a pelvic examination, pregnancy test or infection testing depending on your history.

Get urgent help for heavy bleeding, severe pelvic pain, faintness, fever, or pain and bleeding when pregnancy is possible. Seek prompt review for foul-smelling discharge, pain with urination, or bleeding that continues. Do not wait for a routine visit if symptoms are rapidly worsening.

Could the bleeding come from irritation, infection, the cervix or a pelvic condition? Do I need testing for pregnancy or infection? What symptoms should make me seek urgent care?