Post-Intercourse Bleeding: When to Seek Medical Advice

Postcoital bleeding?

Hello Doctor, I had my first sexual experience with my current boyfriend two years ago, and recently we've been intimate about once a week or once every two weeks.
Over the past month, I've noticed that after intercourse, my discharge has been brownish.
I didn't pay much attention to it at first, but after we had sex yesterday morning, I noticed some blood in the evening, and I still have blood along with brownish discharge now.
I don't have any other discomfort, but I've realized that during intercourse recently, if my partner is too vigorous, I experience some pain (which I didn't seem to have before, although we may not have been as vigorous in the past).
My menstrual period is expected to start on November 21, and my cycle is usually very regular (around 32 days).
I typically use condoms for contraception, but I took emergency contraception about two weeks ago (I also took it a few months ago).
I'm a bit anxious about going to a gynecologist, and I would like to ask the doctor if I need to see one.
Thank you.

Qifu, 10~19 year old female. Ask Date: 2015/11/15

Dr. Lin Wenbin reply Obstetrics and Gynecology

Fear does not help improve the condition; please seek an obstetric and gynecological examination.

Reply Date: 2015/11/15

More Info

Post-intercourse bleeding can be concerning, and it’s important to understand the potential causes and when to seek medical advice. Based on your description, there are a few key points to consider.

Firstly, the presence of brown discharge and blood after intercourse can be attributed to several factors. Brown discharge often indicates old blood, which may be a result of minor trauma to the vaginal walls or cervix during intercourse, especially if the intercourse has been vigorous. This is not uncommon, particularly if there has been a change in the intensity or frequency of sexual activity. The fact that you are experiencing pain during intercourse could also suggest that there may be some irritation or inflammation in the vaginal area or cervix.

The occurrence of blood after intercourse, particularly if it is persistent, warrants further investigation. While it could be a benign issue, such as cervical ectropion (where the cells from the inside of the cervical canal are present on the outside of the cervix), it could also indicate more serious conditions such as cervical polyps, infections, or even precancerous changes. Given that you have also taken emergency contraception recently, it’s worth noting that hormonal fluctuations can sometimes lead to irregular bleeding patterns.

In your case, since you have noticed a change in your body’s response during intercourse, including pain and the presence of blood, it is advisable to seek medical attention. A visit to a gynecologist can help rule out any underlying conditions. They may perform a pelvic exam, and possibly a Pap smear, to assess the health of your cervix and vagina. Additionally, they might conduct tests for sexually transmitted infections (STIs) if deemed necessary.

It’s also important to consider your menstrual cycle. You mentioned that your period is expected soon, and hormonal changes leading up to menstruation can sometimes cause spotting or changes in discharge. However, since you are experiencing these symptoms consistently after intercourse, it’s best not to dismiss them as merely premenstrual symptoms.

In summary, while some causes of post-intercourse bleeding can be benign, the persistence of blood and pain during intercourse should not be ignored. It is recommended that you schedule an appointment with a healthcare provider to discuss your symptoms in detail. They can provide a thorough evaluation and appropriate treatment options if necessary. Remember, it’s always better to err on the side of caution when it comes to your reproductive health.

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