Post Coital Bleeding (Bleeding During or After Sex)

The causes of post coital bleeding can be wide and varied, ranging from benign causes to more sinister causes including cervical cancer.

The bleeding can arise from local causes from the vagina, cervix or more rarely, the womb.

Therefore, it is important for you to arrange for a consultation with your doctor if you have experienced any of such symptoms, so that we may ascertain the cause of the bleeding and start appropriate treatment in a timely manner.

Who gets post coital bleeding?

Postcoital bleeding has a prevalence of up to 9.0 percent and an annual cumulative incidence among menstruating individuals of 6.0 percent. It tends to occur more often in younger individuals in patients ages 20 to 24 years

What are the Common Causes of Post Coital Bleeding?

Infections of any part of the female genital and reproductive tract can result in postcoital bleeding. Sexually transmitted infections, including gonorrhea, chlamydia, and trichomoniasis, can cause cervicitis which is . In addition, upper tract infections, such as pelvic inflammatory disease or endometritis can contribute as well.

Noninfectious causes:

  • Cervical ectropion is the presence of abnormal cells and is commonly found in postpubertal adolescents, pregnant individuals, and those using estrogen-containing contraceptives
  • Cervical polyps and other anatomic lesions – 5 to 18 percent.
  • Missed Pregnancy!

Other common, but less frequent, noninfectious gynecologic causes of postcoital bleeding include:

  • Contraception – These can include changes in bleeding patterns from hormonal contraception as well as increased cervical ectropion from exogenous estrogen exposure.
  • Atrophic vulvovaginal changes – This means thinning of vaginal walls after menopause.
  • Malignancy — Malignancy as a cause of postcoital bleeding occurs in less than 5 percent of patients:cervical cancer is the most common, but vulvar, vaginal, and uterine cancers should be considered too.

How Do You Treat Post Coital Bleeding?

Treatment of post-coital bleeding will depend on the cause. Investigations and examinations will first be carried out to determine the cause.

Does It Mean I Have Cancer?

While post-coital bleeding has a wide variety of causes, it is always important to rule out the presence of cervical cancer.

Cervical cancer can affect anyone from their late teens up to their sixties. It usually peaks in women around their 30s.

It is therefore important for all sexually active women to have regular PAP smear screening.

What Are The Risk Factors for Post Coital Bleeding?

Post-coital bleeding may affect women with multiple sexual partners or those who start becoming sexually active at a younger age.

What can the doctor do for me?

You can start with self swabs to test for vaginal infection which can be done at DTAP Express conveniently.

If required and if your test results at DTAP Express is positive, a doctor’s review will be arranged where further discussion and detailed physical examination will be performed by the doctor and discussion about PAP smear or an Ultrasound Pelvis can be done to evaluate the root cause.