by Dr. Norashikin Mokhtar
There are a few things that can ruin a pleasant post-coital haze – one of them is if your partner immediately rolls onto his back and begins snoring. This can be frustrating, but it is surely not as frightening as going to the bathroom and discovering that you are bleeding!
Bleeding after sex can be due to a number of causes, and usually means that either the skin lining the cervix or vagina is thin or inflamed, or that there is a lesion on the cervix.
It is not to be taken lightly, so if you discover that you are bleeding after intercourse, do see a doctor as soon as possible. Below are the ten most common causes of bleeding after sex.
No. 10 Cervical Dysplasia
One cause of the bleeding could be cervical dysplasia, which means that there are abnormal cells growing on the surface of the cervix. This is a pre-cancerous condition and could lead to cancer if the abnormal cells are not removed.
You may be at risk of cervical dysplasia if you have multiple sexual partners, have sex before age 18, give birth before age 16, or have had a sexually transmitted disease.
Cervical dysplasia can be detected early if you go for regular pap smears. It can be treated with cryosurgery or conisation.
No. 9 Chlamydia
Bacteria is a common culprit of vaginal bleeding. Chlamydia is a type of bacterial infection that is usually sexually transmitted. Apart from bleeding, women with chlamydia may also have abnormal vaginal discharge or feel a burning sensation while urinating.
Chlamydia infection must be treated with antibiotics, or it may lead to future problems like pelvic inflammatory disease and even infertility. To prevent being infected, be sure to practise safe sex and use condoms.
No. 8 Gonorrhoea
Another sexually transmitted bacterial infection that could cause post-intercourse bleeding is gonorrhoea, sometimes called 'the clap'. Just like chlamydia, it can also cause other symptoms like vaginal discharge, burning and pain while urinating, and increased urination.
If the infection spreads, it can cause fever and severe pain in the lower abdomen.
Gonorrhea should be treated with the right type of antibiotics so that it does not cause complications that could lead to infertility.
No. 7 Vaginitis or Cervicitis
Inflammation and infection of the vagina, or of the cervix, could also lead to some bleeding. These conditions could be caused by a bacterial or fungal infection, which can be treated with antibiotics or antifungals.
Sometimes, cervicitis occurs after inserting a foreign device like a cervical cap or a diaphragm into the pelvic area. It can also be caused by an allergic reaction to contraceptive spermicides or to latex in condoms.
No. 6 Cervical Polyps
Sometimes you may have growths in your cervix called polyps. These are smooth finger-like growths that are red or purple in colour. They grow out of the mucous layer of the cervix or the cervical canal, and are extremely fragile.
The good news is, cervical polyps can be removed easily and painlessly by tying a surgical string around the base and cutting it off. The base can be then be removed with electrocautery or with a laser.
No. 5 Trichomoniasis
Another sexually transmitted culprit of bleeding after sex is trichomoniasis, a disease caused by a parasite. It can also cause discomfort during sex, vaginal itching, a greenish-yellow, frothy or foamy vaginal discharge with a foul or strong smell, swelling of the labia and itching of the inner thighs.
Rarely, trichomoniasis can be transmitted through tap water, hot tubs, urine, on toilet seats, and in swimming pools.
This infection can be treated with antibiotics. To prevent from getting it, practise safe and healthy sex.
No. 4 Yeast Infection
Occasionally, the bleeding could be due to a very common condition in women – a yeast infection caused by a fungus called Candida albicans. This infection occurs when the normal fungi that lives in the vagina overgrows and upsets the healthy balance of microorganisms in the vagina.
You may note that you have a yeast infection by the other symptoms, like itching and burning in the vaginal area, as well as an odourless, white vaginal discharge with a cheese-like texture.
You should see your doctor or gynaecologist for proper treatment, especially if it is your first yeast infection.
No. 3 Endometritis or Adenomyosis
Endometritis is the inflammation of the endometrium, which is the innermost layer of the uterus. Adenomyosis occurs when the tissue of the endometrium attaches itself to the uterus or the ovaries, and grows outside of the uterus.
Endometritis can cause other symptoms like general discomfort, fever, lower abdominal or pelvic pain, abnormal vaginal discharge, discomfort with bowel movement (constipation may occur) and an enlarged abdomen. Adenomyosis causes prolonged, heavy and painful menstrual bleeding.
Endometritis can be treated successfully with antibiotics, but adenomyosis may require a hysterectomy.
No. 2 Uterine Polyps
Polyps may also grow in the uterus, which occurs when the endometrium overgrows and protrudes into the uterus. Besides bleeding after sex, you may experience bleeding between periods, excessive or prolonged menstrual bleeding, bleeding after menopause and breakthrough bleeding during hormone therapy.
Uterine polyps can be removed surgically, where the doctor will use a hysteroscope to see inside your uterus and cut away the polyps.
No. 1 Fibroid Tumours
Although the word 'tumour' often means cancer, this is not the case with fibroid tumours. These are solid masses of fibrous tissue that grow in the uterus and are usually benign (non-cancerous).
Although these fibroids can cause post-intercourse bleeding, some women do not experience any symptoms at all.
Fibroid tumours may disappear on their own after menopause. However, they can be treated with various methods such as uterine artery embolisation (cutting off the fibroids’ blood supply), focused ultrasound surgery (using high frequency sound waves to destroy the fibroids), or myomectomy (surgical removal of the fibroids).
Bleeding after sex is nothing to be afraid or ashamed about. It could be caused by just a simple infection or it could be a symptom of another problem that needs to be investigated.
So, do go and see your doctor or gynaecologist immediately; do not wait and hope that the bleeding will go away on its own.
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by Dr. Norashikin Mokhtar