What causes bleeding after sex?

Friction can irritate delicate vaginal tissue, particularly when lubrication is reduced. Cervical ectropion exposes softer cells on the cervix that may bleed with contact, while cervical polyps are small growths that can be disturbed during sex. Chlamydia and other infections may inflame the cervix and cause bleeding, sometimes with discharge, pelvic discomfort, or pain during sex. Genitourinary syndrome of menopause can make vaginal and urinary tissues thinner and drier, making contact more likely to cause spotting. Bleeding can also occur with cervical or vaginal cancer, although these are less common explanations.

Arrange a medical assessment if the bleeding is new, repeats, or has no clear explanation. A clinician may ask about your cycle, contraception, pregnancy possibility, pain, discharge, and screening history, then examine the vagina and cervix. Tests may include a pregnancy test, infection testing, or cervical screening when appropriate. Avoid sex if it causes pain or bleeding until you have advice, and note when the bleeding occurs and how long it lasts.

Seek urgent care for heavy or increasing bleeding, severe lower-abdominal pain, faintness, marked weakness, fever, or bleeding during pregnancy. Prompt assessment is also sensible after menopause, or when bleeding comes with a new pelvic mass, foul-smelling discharge, or unexplained weight loss.

Could dryness, an infection, or a cervical change explain this bleeding? Which examination or tests are suitable for me? Is my cervical screening up to date? Should I avoid sex while this is being investigated?