• Dr Peter Chew

Bleeding after sex

Updated: Nov 14, 2018

I am 30 years old. Recently I noticed some bloody discharge after intercourse? This has happened about 3 to 4 times. What are the causes? Should I see a gynaecologist? What examination or tests would he/she do?

A. There are many reasons why a woman bleeds or has bloody discharge after sex. The medical term for this condition is called "post-coital bleeding"(PCB).While the bleeding may be alarming, it is not that uncommon affecting up to 10 percent of women of reproductive age. Although it is called "vaginal" bleeding, most of the time it comes from the neck of the womb(cervix). Other parts of the genital and urinary systems may also be involved.The most common cause for PCB is inflammation of the cervix, or cervicitis. It can result from a sexually transmitted infection, such as chlamydia or gonorrhoea or from a non-infectious cause such as allergic reactions to feminine douches. An overgrowth of some of the bacteria that are normally present in the vagina, a condition known as bacterial vaginosis, can also cause cervicitis. The second common reason for bleeding after sex is the presence of a cervical polyp. These are usually non-cancerous growths. (see cervical polyp in the website)

Other causes of PCB include:

  • Vaginal dryness caused by reduced vaginal secretions,

  • Vaginal infection,

  • Vagina tears from childbirth,

  • Genital sores caused by herpes or other infections,

  • Cancer of the cervix, vagina, or uterus.

While many of the causes are harmless, occasionally, PCB can be a sign of a more serious problem such as cancer or precancer of the genital tract. If the PCB is repeating itself as in your case, you should consult the gynaecologist to find out the cause so that appropriate treatment can be given. The gynaecologist will probably ask you some questions to see if there is an obvious reason for the bleeding. He or she may also want to know if you are having pain during sex, which can be a sign of inadequate lubrication or infection. A vaginal speculum will be used to open the vaginal walls to look for the source of the bleeding in the cervix or vagina. A swab of the vaginal discharge will be taken to test for sexually transmitted infections like chlamydia and gonorrhoea. A Pap smear test will also be done to detect any sign of abnormal, precancerous growths or cancer cells of the cervix. If the Pap smear test reveals any abnormalities, your gynaecologist may advise further test using a special magnifying device called colposcope to get a closer look at the cervix. (see colposcopy in the website)

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