Vaginal bleeding during and after sex: what to know

Friction, a small surface tear, vaginal dryness, or inflammation can cause light bleeding. Changes on the cervix, including cervical dysplasia or cervical cancer, can also present with bleeding after sex. Chlamydia and other infections may cause bleeding alongside discharge, pelvic discomfort, or pain when urinating. After menopause, thinner and more delicate vaginal tissue can bleed with contact; this can occur with genitourinary syndrome of menopause. Vaginal cancer is uncommon, but abnormal bleeding is a reason for examination rather than self-diagnosis.

Note when the bleeding happens, how long it lasts, whether it follows penetration, and whether you have pain, discharge, or a missed period. Pause penetrative sex if it causes fresh bleeding or discomfort. Arrange a gynaecology or primary-care appointment for bleeding that returns, occurs after menopause, or has no clear explanation. Assessment may include an examination, pregnancy testing, infection testing, and cervical screening or further tests when indicated. A cone biopsy is one procedure clinicians may use to investigate or treat selected cervical changes.

Seek urgent medical help for heavy or rapidly increasing bleeding, severe lower-abdominal pain, faintness, marked weakness, fever, or bleeding when pregnancy is possible. Get prompt assessment if bleeding follows sexual assault or an injury. Do not wait for a routine appointment when you feel unwell or symptoms are worsening.

Could dryness, an infection, or a cervical change explain this bleeding? Do I need pregnancy or infection testing? Is my cervical screening up to date? Which symptoms should make me seek urgent help?