Post-Coital Bleeding

Bleeding or spotting during or after sexual intercourse is known as post-coital bleeding.  Post-coital bleeding is not linked to menstruation.

Cause

Post-coital bleeding can be due to a variety of reasons most of which are not serious like cervical polyps or cervicitis.  Bleeding due to cervical cancer is a cause for concern, however, it is very unlikely.  Post-coital bleeding occurs mainly due to lesions found on the surface of genitalia, examples are cervical polyps, ectropion, cervical intra-epithelial lesion (CIN) or cancer.

Pelvic inflammatory disease (PID), sexually transmitted infections (STI), vaginal dryness due to menopause, trauma to the vagina or vaginal irritation during sex are some of the other causes of post-coital bleeding.

What are the symptoms?

Bleeding after sexual intercourse, it could be just spotting or bleeding.

What tests will be required for diagnosis?
  • Physical examination by your doctor
  • Ultrasound scan
  • CT/ MRI scan
  • Pap smear
What are the treatment options available?
  • Lubricants: The common cause of post-coital bleeding is vaginal dryness.  Menopause and inappropriate vaginal lubrication during sex are some of the reasons of vaginal dryness.  Vaginal moisturisers and lubricants are effective treatments of vaginal dryness.  They keep the vaginal walls moisturised and retain the natural acids of the vagina.  A well lubricated vagina also minimises friction during intercourse.  It is advisable to avoid parabens or propylene glycol containing lubricants. Water-based and silicone-based lubricants are more vagina friendly.
  • Estrogen Therapy: If menopause or ovarian resection is the cause of vaginal dryness, then hormone replacement therapy like estrogen can restore moisture in the vagina.  Estrogen products can be taken orally, applied on the surface or inserted in the vagina.  A flexible estrogen ring is another option to treat vaginal dryness.