I am 28 and have been dating my boyfriend for over a year and at least once a month, I bleed after sex. Sometimes it is a little bit and sometimes it is a lot and I need to wear a tampon afterward. I have been to my gyno twice telling her how nervous I am, and she says that everything looks normal. I am realizing that it usually happens when I am on top. Any advice?
--Wanting Cuddles Not Kotex
Dear WCNK,
Nothing kills a post-sex high like bleeding in the bathroom (or in bed). I don't worry when a patient has one episode of post-coital bleeding, but you've been bleeding like this for quite a while. There are multiple reasons why we may bleed after the deed:
- Infections. Chlamydia, gonorrhea, trich, even a wicked yeast infection can cause enough inflammation in your cervix or vagina to cause bleeding. Your gyno can test you for all of these with a pelvic exam.
- Trauma. Small scratches or lacerations can be caused with really vigorous sex, especially with toys, fingernails, or not enough lube. Try to see your gyno the day after a bleeding episode for her to rule this out.
- Polyps. These are fleshy overgrowths in your cervix or uterus--think skin tags the size of a golf pencil--that can cause irregular bleeding. Your gyno can often pick these up on an ultrasound.
- Hormonal imbalance. Abnormalities of your thyroid or prolactin hormone can cause irregular bleeding, and can be checked by a blood test.
- Cervical dysplasia. It's unusual, but post-coital bleeding can point to pap smear abnormalities--make sure your pap is up to date.
- Fibroids and endometriosis. Also unusual. These are usually present with other symptoms, too, that your gyno will pick up in your history.
- Period jump-start. If you're seeing bleeding in the days before your period starts, it may be the first signs of menses (sex can "shake loose" the first drops). Similarly, if it's in the day or so after your period ends, it may be the leftover blood that you see.
If your gyno has ruled all of these out, your bleeding may remain a mystery for now...but try not to worry. If none of these causes show up, your gyn health is clearly excellent, and something to celebrate.
Have any of you had bleeding after sex?
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