What Causes Bleeding After Sex With No Pain?

That comfortable, glowing feeling after sex can be shattered by sudden bleeding.

If you’ve just finished having intercourse, and it was a great experience, but you’re bleeding, alarm bells are likely going off. What causes bleeding after sex with no pain?

Let’s take a look at understanding bleeding after sex and some possible reasons for it.

What Is Bleeding After Sex?

The condition of post-sex bleeding is called postcoital bleeding. This is spotting or bleeding that occurs after intercourse that is not related to menstruation.¹

If it’s happened to you, you’re not alone. The prevalence of postcoital bleeding is estimated to range up to 9 percent of menstruating women. About 30 percent of patients with postcoital bleeding also experience abnormal uterine bleeding and 15 percent have dyspareunia, which is when you suffer pain during intercourse.¹

Postcoital bleeding mainly comes from surface lesions, such as cervical polyps. But it can also be a sign of something serious, including in some cases cervical cancer. The chance of cervical cancer in women with postcoital bleeding is 3.0 to 5.5 percent.¹

What Causes Bleeding After Sex?

If you aren’t menstruating, the sight of blood after sex is alarming. It’s even more so if you don’t experience pain.

Here are some possible reasons:

It May Not Be Serious

Spots of blood could be the result of friction during sex, such as that caused by inadequate lubrication or not enough foreplay.² It could also be due to damage to the vagina, such as tears caused by childbirth.³ You may also suffer injury to the uterine lining during intercourse, especially if you’re taking oral contraceptives.²

It may even mean that your period has arrived without you knowing. But if you’re postmenopausal, vaginal bleeding at any time must be evaluated. See your doctor to be sure that the cause of your vaginal bleeding isn’t something serious.⁴

There are other possibilities. It could be vaginitis, an inflammation of the vagina that sometimes has other symptoms: discharge, itching and pain. Vaginitis is usually caused by a change in the balance of vaginal bacteria or an infection of the reproductive organs or reduced estrogen levels after menopause. Some skin disorders also can cause vaginitis. Treatment varies depending on the type of vaginitis you have.⁵

Occurring most often after menopause, some women suffer from vaginal atrophy. The thinning, drying and inflammation of the vaginal walls may be caused by a drop in estrogen.⁶ You could also be suffering from vaginal dryness, a problem for women at any age, although it is more common after menopause.⁷

Here are some of the less serious and more common potential causes of light bleeding after intercourse:

1. Vaginal Dryness: Insufficient vaginal lubrication during sexual activity can lead to friction and minor irritation, which may result in light bleeding. This is more common in women who are perimenopausal, menopausal, or breastfeeding.
   
2. Cervical Ectropion: Cervical ectropion, also known as cervical erosion, is a benign condition where the cells from the cervical lining appear on the outer surface of the cervix. These cells are more delicate and prone to bleeding, especially during intercourse.
   
3. Vaginal or Cervical Infections: Infections, such as yeast infections or bacterial vaginosis, can cause inflammation and irritation of the vaginal or cervical tissues, leading to bleeding.
   
4. Trauma or Minor Injury: Rough or vigorous sexual activity, or the use of sex toys, can sometimes cause minor trauma to the vaginal or cervical tissues, resulting in light bleeding.
   
5. Use of Certain Birth Control Methods: Hormonal birth control methods like birth control pills or intrauterine devices (IUDs) can occasionally cause hormonal changes that lead to light spotting, especially in the initial months of use.
   
6. Endometrial Polyps: While more uncommon, small growths called endometrial polyps within the uterus can sometimes lead to postcoital bleeding when they come into contact with the cervix during sex.
   
7. Benign Cervical Growth: Noncancerous growths like cervical polyps can cause bleeding, especially if they are disturbed during intercourse.
   
8. Hormonal Fluctuations: Hormonal changes during the menstrual cycle can sometimes lead to light spotting after sex, particularly around the time of ovulation.
   

It Could Be More Serious

There are other conditions that could cause bleeding after sex:

• an infection, such as pelvic inflammatory disease (PID)²
• endometriosis, which like PID can cause abnormal uterine bleeding
• a sexually transmitted infection (STI), such as chlamydia³
• cervical or endometrial polyps (benign or non-cancerous growths in the womb or the lining of the cervix)³
• uterine fibroids, which along with polyps can cause bleeding between menstrual cycles
• cervical ectropion (also known as cervical erosion), where there is an inflamed area on the surface of the cervix³

Since there are a number of causes that could be associated with the symptom of bleeding after sex, it’s vital that you see a health care professional for an accurate diagnosis. Your pelvic health is vital to your overall health.

Symptoms to Watch For After Postcoital Bleeding

In addition bleeding, there are several other symptoms that a woman should be aware of and consider when experiencing post-sex bleeding. These symptoms can provide important clues about the underlying cause of the bleeding and may help guide medical evaluation and diagnosis. Here are some additional symptoms to watch for:

1. Vaginal Discharge: Pay attention to any unusual vaginal discharge, especially if it has an unusual color, odor, or consistency. Changes in vaginal discharge can sometimes accompany post-sex bleeding and may indicate an infection or other issue.
   
2. Pain During Intercourse: If you experience pain or discomfort during sexual intercourse, it’s important to note this symptom. Painful intercourse, also known as dyspareunia, can be related to various gynecological conditions.
   
3. Fever or Chills: The presence of a fever or chills along with post-sex bleeding may indicate an infection, particularly a sexually transmitted infection (STI).
   
4. Burning or Itching: If you experience burning, itching, or irritation in the genital area, it could be a sign of an infection or inflammation. This includes inflamed or red vaginal tissue.
   
5. Pelvic Pain: Besides abdominal pain, any pelvic pain or discomfort that persists after intercourse should be reported to a healthcare provider. It can be associated with gynecological issues.
   
6. Changes in Menstrual Cycle: If post-sex bleeding is accompanied by irregularities in your menstrual cycle, such as heavier or more prolonged periods, this information is relevant for diagnosis.
   
7. Painful Urination: Pain or discomfort while urinating can sometimes be related to infections or conditions that may also cause post-sex bleeding.
   
8. Rectal Bleeding: In some cases, rectal bleeding can be mistaken for vaginal bleeding. It’s important to differentiate the source of bleeding accurately.
   
9. Abnormal Growth or Mass: If you notice any abnormal growths, lumps, or masses in the vaginal or pelvic area, report these findings to a healthcare provider.
   
10. Pain or Discomfort in Lower Back: Sometimes, pain in the lower back may accompany post-sex bleeding, and it can be associated with certain gynecological conditions.
    

Heavy Bleeding After Sexual Intercourse

If you are experiencing heavy bleeding and abdominal pain after sex but, are not menstruating, it’s important to take these symptoms seriously and seek medical attention promptly. These symptoms could be indicative of various underlying issues, and it’s essential to determine the cause and receive appropriate treatment.

If you experience heavy bleeding and any type of pelvic pain pain during or after sex, stop sexual activity immediately to prevent any further aggravation of the symptoms.

Seek Immediate Medical Attention

Contact a healthcare provider or go to the nearest emergency room as soon as possible. Do not delay seeking medical help, especially if the bleeding is excessive or the pain is severe.

Possible Causes

There are several potential causes for heavy bleeding and abdominal pain after sex, including:

• Cervical Issues: Conditions like cervical polyps, cervicitis, or cervical ectropion can cause bleeding and discomfort during or after intercourse.
• Infections: Sexually transmitted infections (STIs) or other genital infections can lead to these symptoms.
• Uterine Issues: Conditions like fibroids or endometriosis can cause pain and bleeding.
• Trauma or Injury: Sometimes, vigorous or rough intercourse can result in vaginal or cervical trauma.
• Other Gynecological Conditions: There could be other gynecological conditions or issues causing these symptoms.

The Danger of Cancer

Don’t be too alarmed, since most patients with postcoital bleeding do not have cancer, or what doctors call “an underlying malignancy.”¹ But you still need to be cautious, and ensure you’re receiving proper medical care and getting your regular examinations, such as cervical screening tests.³

In rare instances, bleeding after sex can be a sign of cervical cancer or vaginal cancer.³ Abnormal vaginal bleeding can also be a sign of endometrial (uterine) cancer.⁸

Some women with postcoital bleeding don’t even have an obvious source for their bleeding, and symptoms naturally resolve themselves.¹ But that doesn’t mean you should ignore bleeding after sex.

See a Doctor

If you have experienced bleeding after sex, pain during sex or even without feeling pain, it’s worth seeing a doctor. Use our Physician Finder to seek out a women’s health specialist, and ensure you have a proper examination, diagnosis, and annual screenings. It’s important to diagnose and treat your health concerns.