Bleeding after vaginal sex

Also known as post-coital bleeding

Key points about bleeding after sex

  • When you have vaginal bleeding after having sex it's known as post-coital bleeding.
  • If you have vaginal bleeding and it is not due to your period, see your healthcare provider.
  • Normally it is nothing to worry about but, in some cases it could be a sign of something more serious.
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Post-coital bleeding is vaginal bleeding that occurs within 24 hours after sexual intercourse.

Normally you should only have vaginal bleeding when you have a period, but if you have irregular periods, you may not be sure if the bleeding is normal or not. If you're not sure if your bleeding is part of a period, talk to your healthcare provider about it. 

Heavy bleeding immediately after sex is not normal – seek urgent medical help.

A woman's reproductive system can be divided into upper and lower parts:

  • The upper part includes the body of your uterus, your fallopian tubes and your ovaries. Bleeding during your period occurs when the lining of your uterus breaks down as part of a normal monthly cycle.
  • The lower part of a woman’s reproductive system is the neck of your womb (cervix), your vagina, and your vulva and labia, which are on the outside of your body. 

It is the lower parts that are usually involved in post-coital bleeding. 

Common causes of post-coital bleeding

Cervical polyps

Polyps occur when some cells in an area grow too much. They can occur in many parts of your body and are usually not serious. Because a polyp is made of cells that have grown abnormally, they can occasionally develop into a cancer. This is how many bowel cancers are thought to start.

Cervical polyps often occur in women with polyps inside your uterus. If the polyps grow too much they can bulge out of the opening of your cervix into your vagina. The cells on polyps are not tough like skin, so if they are rubbed during intercourse they will bleed.

Rarely, cervical polyps develop into cancer of the lining of the womb, called endometrial cancer. Endometrial cancer is not usually detected with cervical screening but does usually cause irregular vaginal bleeding before it is very advanced, so there is a good chance of a cure. Read more about cervical polyps.

Cervical ectropion

This condition is not serious but is one of the more common causes of post-coital bleeding. Sometimes female hormones cause the cells inside your cervix to grow outward into the part of your cervix that your doctor and nurse can see if they do an internal examination. This is why sometimes you may have some bleeding after a cervical sample (smear).

Cervical ectropion is similar to cervical polyps except that the cells have not grown too much and are not abnormal, they are just in the wrong place on the outside part of your cervix, where they can be damaged during sex. Read more about cervical ectropion.


Occasionally a bad case of thrush can cause bleeding. Usually, there will be a lot of discharge and discomfort as well. You can buy treatment for thrush over the counter at a pharmacy. If you treat thrush but the bleeding doesn’t go away or if you get thrush often, see your healthcare provider for a check-up. Recurrent thrush can be a sign of diabetes. Read more about thrush.

Bleeding due to the contraceptive pill or injection

When you first start taking 'the pill' or 'the injection' you can have some irregular bleeding for 2–3 months. Irregular bleeding when on the injection is quite common and is one of the main reasons women stop using this form of contraception.

If you are sexually active and are not planning to become pregnant, there are many effective different types of contraception. Go to Sexual Wellbeing Aotearoa(external link) or your healthcare provider to discuss the choices and find a method of contraception that works for you.

Bleeding caused by sex

Occasionally, sex can cause bleeding from your vagina or vulva. This may occur sometimes the first time you have sex but it should not be heavier than a period or last more than a couple of days. Read more about hymens and virginity.

Although sexual activity does not usually cause damage to your vagina, a rip or tear in your vagina can sometimes occur. Your vagina has a lot of blood vessels just under the surface, so the bleeding can be very heavy and requires management in a hospital.

Bleeding from your vagina after sex is more common if you have gone through menopause and stopped having periods.

  • This is often associated with a condition called atrophic vaginitis where the lining of your vagina becomes thinner and more susceptible to infection.
  • Women on medications for breast cancer (such as tamoxifen) may also have this condition due to low hormone levels.

Using a water-based lubricant during sex can help prevent bleeding if this is the cause. 

Read more about menopause.

Less common but more serious causes of post-coital bleeding

Cervical cancer

Cervical cancer is a serious condition but if it is treated early it can be cured completely. Fortunately, this cancer can be identified through cervical screening tests before it becomes a serious threat.

Cervical screening is a very effective way of preventing cervical cancer. The chances of getting cervical cancer if you have regular screening is very very low.

However, no test is perfect, so even if you have had a recent cervical screening test, you should still see your healthcare provider if you have post-coital bleeding. 

Read more about cervical screening and cervical cancer.

Cervical infection

Infection of your cervix is usually a sexually transmitted infection (STI). Some STIs, such as chlamydia and gonorrhoea, are serious and need to be treated. The infection can spread from your cervix to your uterus and fallopian tubes and cause problems getting pregnant. Because they are sexually transmitted, your sexual partner/s will also need to be checked for infection.

Condoms are a very effective protection against infections such as chlamydia and gonorrhoea. They also protect against pregnancy and serious conditions such as HIV. 


Bleeding in early pregnancy is common. Most women will know they are pregnant soon after missing a period, but many others won't realise they are pregnant for a couple of months. If early pregnancy bleeding occurs around the time you are expecting a period, it is easy to mistake this for a period.

There are several important reasons to find out whether you are pregnant:

  • If you are pregnant and plan to continue the pregnancy you may need to change lifestyle behaviours, such as smoking or drinking alcohol, to make sure your baby gets the best possible start in life.
  • The treatment of bleeding in early pregnancy is very different to treatment of post-coital bleeding
  • Your GP may not want to prescribe some medications if you are pregnant.
  • Early pregnancy bleeding can occur with an ectopic pregnancy, which occurs when the pregnancy is growing in a fallopian tube. This is potentially very dangerous.

Read more about pregnancy.  

It's not normal for girls who haven't started having periods to have vaginal bleeding. See your healthcare provider for advice. 

How is post-coital bleeding diagnosed?

To find out the cause of the bleeding, your healthcare provider will need to ask you some personal questions about your sexual activity. These questions can be a bit embarrassing but remember, they talk about this kind of thing all the time. The more information you can give the easier it will be for them to find out what's going on. 

Your healthcare provider will also need to find out about:

  • any contraception you're using
  • any other medications you're on
  • when you last had cervical screening.

If you're not seeing your regular healthcare provider it can be really helpful to take along your medicines, eg, 'the pill' if you are using it.

Tests and procedures

Your healthcare provider may ask you to have one or more common tests and procedures done. They could include: 

  • A urine sample to check for pregnancy or urine infection.
  • A vaginal examination to look for causes of bleeding in your vagina or cervix. 
  • A cervical sample test might be done (was called smear test) and tests for infection can be done at the same time.
  • Occasionally your doctor may also do a test called a pipelle. This is done using a very thin plastic tube to collect a sample of the lining of the uterus. They will want to know whether you are pregnant before this test.
  • An ultrasound scan, especially if your pregnancy test is positive, the examination suggests there is a problem with your uterus or ovaries, you are over 45 years old or if there is a family history of certain types of cancer.

What is the treatment for post-coital bleeding?

Treatment for post-coital bleeding will depend on what the cause is. Your healthcare provider will advise you on the best course of action once a diagnosis has been made. 


Wan YL, Edmondson RJ, Crosbie EJ. Intermenstrual and postcoital bleeding(external link)(external link) Obstetrics, Gynaecology and Reproductive Medicine. 2015;25:4:107-12.

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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Dr Jeremy Tuohy, Obstetrician & Researcher, University of Auckland

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