Pain and Bleeding During Sexual Activity: A Guide for Young Women

There may be pain in the lower body?

Hello Doctor, I am 19 years old and have already engaged in sexual intercourse.
After my period last month, I experienced significant bleeding during intercourse, so I stopped.
A few days later, I had intercourse again and there was some bleeding, which gradually decreased.
I visited a doctor who performed a pelvic exam and found no issues.
They suggested I could have a Pap smear.
I have received the HPV vaccine; do I still need to get tested? I also experience brown discharge after my period; is this normal? Additionally, I feel some pain in my genital area when I have vaginal lubrication, but it goes away after a while.
Could this indicate an infection? Since I have a uterus didelphys (double uterus) and a double vagina, I am unsure if there could be a hidden infection on that side.
The last time I saw a doctor, both the pelvic exam and ultrasound were normal.
Thank you, Doctor.

Niming, 10~19 year old female. Ask Date: 2017/03/25

Dr. Huang Jianzhong reply Obstetrics and Gynecology

1.
After my period last month, I experienced significant bleeding during intercourse, so I stopped.
A few days later, I had intercourse again and noticed some bleeding, which was decreasing.
I visited a doctor, and the pelvic exam showed no issues.
The doctor suggested I could have a Pap smear.
I have received the cervical cancer vaccine; do I still need to get checked? Answer: Yes, it is necessary to get checked.
2.
I always have brown discharge after my period; is this normal? Answer: An ultrasound, blood test, or hysteroscopy may be needed.
3.
I experience some pain in my lower region when I have vaginal discharge, but it goes away after a while.
Is this an infection? Answer: "Experiencing some pain in the lower region when having vaginal discharge that goes away after a while" is not indicative of an infection; it should be fine.
4.
I have a uterus didelphys (double uterus) and a double vagina, so I am unsure if there could be a more hidden infection on one side.
Answer: A uterus didelphys and double vagina would not typically lead to a more hidden infection.

Reply Date: 2017/03/25

More Info

Understanding pain and bleeding during sexual activity can be a complex issue, especially for young women who are navigating their sexual health for the first time. It's important to recognize that experiencing pain and bleeding during or after sex is not uncommon, but it should be addressed to ensure there are no underlying health issues.

Firstly, let's discuss the potential causes of pain and bleeding during sexual activity. There are several factors that could contribute to these symptoms:
1. Anatomical Variations: In your case, having a double uterus and double vagina could potentially lead to unique anatomical challenges. This may affect how sexual activity feels and could contribute to discomfort or pain during intercourse.

2. Vaginal Dryness: Even with adequate foreplay and the use of lubricants, some women may still experience vaginal dryness, which can lead to friction and discomfort during sex. This can be exacerbated by hormonal fluctuations, stress, or certain medications.

3. Infections: Pain during sexual activity can sometimes indicate an infection, such as a yeast infection or bacterial vaginosis. These infections can also lead to unusual discharge or bleeding. If you notice any changes in your discharge, such as an unusual odor or color, it’s important to consult a healthcare provider.

4. Cervical Issues: The cervix can be sensitive, and any trauma or irritation during intercourse can lead to bleeding. This is particularly relevant if you have had recent pap smears or cervical vaccinations, as these can sometimes cause temporary sensitivity.

5. Psychological Factors: Anxiety and stress can also manifest physically, leading to muscle tension in the pelvic area, which can cause pain during sex. It’s essential to ensure that both partners are comfortable and relaxed.

Regarding your specific concerns about the brown discharge after your period, this is often normal and can be attributed to old blood leaving the body. However, if the discharge is accompanied by a foul odor or significant discomfort, it would be wise to seek medical advice.

You mentioned that you have already undergone examinations, including an internal exam and ultrasound, which did not reveal any issues. This is reassuring, but if you continue to experience pain and bleeding, it may be beneficial to follow up with your healthcare provider. They may recommend additional tests, such as a pap smear, to rule out any cervical issues or infections that may not have been apparent during the initial examination.

In summary, while some discomfort and bleeding can be normal, especially in the context of new sexual experiences, persistent or severe symptoms warrant further investigation. It’s crucial to maintain open communication with your healthcare provider about your symptoms and any concerns you may have. They can provide tailored advice and treatment options based on your specific situation. Remember, your sexual health is an important aspect of your overall well-being, and seeking help is a proactive step towards ensuring it remains healthy.

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