Abnormal Bleeding After Intercourse: Causes and When to Get Tested

Abnormal bleeding

Hello, doctor.

1.
A few days ago, after having sexual intercourse with my boyfriend, I experienced a little bit of bright red bleeding, but it was not painful.
My last menstrual period started on October 24.
I’m wondering if this has any significant impact.
What are the common causes of post-coital bleeding?
2.
How many years after starting sexual activity should one get a Pap smear? It has been four years since my first sexual encounter; am I eligible to start screening? Thank you, doctor.

Yeri, 20~29 year old female. Ask Date: 2018/10/21

Dr. Huang Jianzhong reply Obstetrics and Gynecology

1.
A few days ago, after having sexual intercourse with my boyfriend, I experienced a little bit of bright red bleeding that was not painful.
My last menstrual period started on September 24.
I’m not sure if this has any significance.
What are the common causes of post-coital bleeding? Answer: You need to visit a hospital for an examination to determine the cause.
2.
How many years after starting sexual activity should a Pap smear be done? It has been four years since my first sexual encounter; can I start getting checked now? Answer: A Pap smear should be performed 1-3 years after the onset of sexual activity.

Reply Date: 2018/10/21

More Info

Abnormal bleeding after intercourse can be concerning, and understanding its potential causes is essential for addressing any underlying issues. In your case, experiencing a small amount of bright red bleeding after sexual activity, especially if it is not accompanied by pain, can be attributed to several factors.

1. Causes of Post-Coital Bleeding:
- Cervical Ectropion: This condition occurs when the cells from the inside of the cervical canal are present on the outside of the cervix. It can lead to increased sensitivity and bleeding after intercourse, particularly if there is friction during sexual activity.

- Infections: Sexually transmitted infections (STIs) or other infections of the reproductive tract can cause inflammation and bleeding. Conditions like cervicitis (inflammation of the cervix) can also lead to post-coital bleeding.

- Polyps or Fibroids: These benign growths in the uterus or on the cervix can cause bleeding during or after intercourse.

- Hormonal Changes: Fluctuations in hormone levels, particularly around the time of your menstrual cycle, can lead to increased sensitivity and bleeding.

- Vaginal Dryness: Insufficient lubrication during intercourse can cause minor tears in the vaginal lining, leading to bleeding.

Given that your last menstrual period was on October 24, it is possible that hormonal changes or other factors related to your cycle could be influencing this bleeding. If the bleeding persists, increases in volume, or is accompanied by pain, it is advisable to seek medical attention for further evaluation.

2. When to Get Tested:
- If you experience recurrent post-coital bleeding, or if it is accompanied by other symptoms such as unusual discharge, pelvic pain, or changes in your menstrual cycle, it is essential to consult a healthcare provider. They may recommend a pelvic exam, Pap smear, or other tests to rule out infections, polyps, or other conditions.

- Regular gynecological exams, including Pap smears, are recommended to start at age 21, regardless of sexual activity. Since you mentioned that you have been sexually active for four years, it would be prudent to schedule a Pap smear if you have not done so already. This screening helps detect cervical cancer and other abnormalities early on.

In summary, while occasional light bleeding after intercourse can be normal, it is crucial to monitor your symptoms. If the bleeding continues or worsens, or if you have any concerns about your reproductive health, do not hesitate to consult a healthcare professional. Regular screenings and open communication with your doctor are vital for maintaining reproductive health.

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