Postcoital bleeding. What is the cause of bleeding after sexual intercourse? Polyps and fibroids of the cervix and endometrium

Bleeding after intercourse, or postcoital bleeding, most often do not pose a danger to the woman, however, you should still be wary and report the incident to the gynecologist. There are many reasons for this, and some of them may be very alarming. Let a specialist determine the degree of danger.

Causes

• The cause of such bleeding may be mechanical, in the form of injuries as a result of overly active sex. In this case, injury or rupture of the vault or vaginal wall, disruption of the mucous membrane or. If postcoital bleeding appears suddenly and is accompanied by severe pain, you should immediately call an ambulance; this requirement applies to all dangerous injuries that are accompanied by bleeding;
• A more common cause of bleeding after intercourse is infections, this is mainly chlamydia or others;
• Inflammatory processes, developing in the female genital organs may also well cause this kind of bleeding that occurs after sexual contact. Inflammation can also be initiated by normal human flora - fungi, staphylococcus, E. coli, and other microorganisms. This flora can penetrate into the female genital tract from the male genital organs or the oral cavity, and already in the vagina their intensive reproduction begins, followed by inflammation, the speed of which is influenced by the woman’s reduced immunity, menstruation or pregnancy. Both of these diseases are not so dangerous for women; they can be easily and quickly treated with antibiotics. An advanced inflammatory process may require a cauterization procedure, which is also not complicated and quite effective;

• A common cause of bleeding after intercourse is polyps and erosions, which the doctor can cauterize to return the woman to a full life. Doctors usually recommend removing polyps. This operation is also not difficult; it is performed on an outpatient basis;
• Due to taking medications;
• Much less commonly, postcoital bleeding is caused by pathological changes in cervical cells, cancer and a number of blood diseases. Here it is necessary to examine vaginal discharge.

Very often, postcoital bleeding is caused by an inflammatory process that irritates the cervix - cervicitis, or vaginitis, which is an inflammation of the vagina. In both cases, however, bloody discharge from the female genitalia may not be associated with sex or the end of sexual intercourse.

Inflammatory processes in the female genital organs themselves can be provoked not only by infectious or fungal diseases, but also by the use of various medications, or violation of personal hygiene rules, which also occurs quite often.

A number of drugs, in particular aspirin, anti-clotting agents, can also initiate such bleeding. This effect, in this case, is due to hypoplasia of the uterine mucosa (reduction in the thickness of the inner lining) as a result of taking medications.

Sometimes, women violate the regimen for taking hormonal medications, this primarily applies to contraceptives, when, due to omission or delay in taking them, postcoital bleeding is provoked.

And, although it is still worth contacting a doctor, most cases of bleeding after sexual intercourse do not pose any danger to a woman’s life, but they should be responded to in a timely manner.

However, if bleeding after sexual intercourse is accompanied by acute pain in the lower abdomen, genitals, inguinal folds, lower back, perineum, then this may be a manifestation of various complications - rupture of the ovary or ovarian cyst, disruption or termination of an ectopic pregnancy.

When is an ambulance needed?

Such conditions are dangerous for a woman; in this case, hurry up and call an ambulance, especially if these symptoms are accompanied by:

• increased heart rate
• acute pain
• a sharp drop in blood pressure
• pale skin
• weak pulse
• sweat profusely
• frequent urge to urinate

Postcoital bleeding is a type of pathological bloody vaginal discharge. In many cases, this symptom is a manifestation of non-life-threatening diseases; it is also one of the main signs of a malignant tumor of the cervix. When bloody discharge is observed after or during sexual intercourse, you should consult a gynecologist.

Definition and prevalence

Pathological discharge has no connection with the menstrual cycle. They can occur on any day, be almost invisible or quite intense, and be accompanied by pain during sexual intercourse.

This symptom is observed in 1-9% of women during the fertile period.

In 30% of patients with this symptom, abnormal uterine bleeding is simultaneously present, and in 15% there is pain during sexual intercourse.

Depending on the level of damage to the genital organs, the nature of bloody discharge may be different:

• when the uterus is involved, blood clots formed in its cavity may be released;
• if a pathological process, for example, inflammation, affects the cervix, mucus with blood appears;
• when the outer part of the cervix or vaginal walls is affected, scarlet blood is released.

With intense bleeding, the possibility of internal bleeding cannot be excluded, for example, due to vaginal injuries. Therefore, it is necessary to immediately call a doctor if, along with vaginal discharge, there are the following signs:

• increasing abdominal pain;
• bloating;
• pallor of the skin and mucous membranes;
• cold sweat;
• weak pulse;
• rapid heartbeat;
• shortness of breath, severe weakness;
• drop in blood pressure, dizziness, fainting.

Causes

The main reasons for the appearance of blood after sexual intercourse:

1. Benign formations: polyps of the uterus, its cervix and ectropion.
2. Infections: cervicitis, pelvic inflammatory disease, endometritis, vaginitis.
3. Lesions of the external organs of the reproductive system: herpes, genital warts, chancroid.
4. Vaginal atrophy in old age, pelvic organ prolapse, benign vascular neoplasms (hemangiomas), endometriosis.
5. Malignant formations of the cervix, vagina, endometrium.
6. Injury due to sexual assault or the presence of a foreign body.

If a woman leaks blood during intercourse, the risk of cervical cancer ranges from 3 to 5.5%, and the risk of cervical intraneoplasia is up to 17.8%.

In a significant proportion of patients, in more than half of the cases, doctors are unable to figure out why coitus provokes bleeding. However, the pathological condition should be considered as a potential indicator of cervical neoplasia (precancer) and cervical cancer.

Discharge of blood after sexual intercourse is typical for women of reproductive age, and it is observed less frequently in young patients.

There are physiological reasons for this condition:

1. In a girl after her first sexual intercourse, her hymen is damaged.
2. In the middle of the cycle, a little blood may be released during.
3. Bloody discharge before menstruation may be a sign of implantation of a fertilized egg into the endometrium.
4. Vaginal discharge may occur during the first weeks after birth, until the uterus has fully recovered.
5. Bleeding after sexual intercourse during pregnancy is normal and does not require treatment. This should be reported to the observing gynecologist at your next visit.

Bloody discharge can be observed during sexual intercourse, immediately after it and after some time. If blood appears immediately after sexual intercourse, diseases of the vagina and the outer part of the cervix are most likely. In these pathologies, the damaged tissue is mechanically injured, which is accompanied by a violation of the integrity of the blood vessels.

If bleeding is more common the day after sexual intercourse, it is necessary to exclude pathology of the endometrium, that is, the inner uterine layer. In this case, the mechanical effect is not so significant; greater importance is attached to increasing blood flow in the walls of the uterus. In this case, pathologically altered tissues have increased vascular permeability. Red blood cells emerge from the arteries, accumulating first in the uterus and after some time exiting through the cervical canal into the vaginal cavity.

Major diseases accompanied by bleeding

Malignant tumor

Postcoital bleeding occurs in 11% of women with. This disease is the second most common cancer among women worldwide. The average age of onset of pathology is 51 years. The main risk factor is HPV infection, as well as decreased immunity and smoking.

In recent years, the incidence of postcoital bleeding in cervical cancer has decreased significantly. This is due to earlier diagnosis of the tumor, when the tissues have not yet disintegrated and the vessels have not been damaged. Cytological screening of the cervix and testing for HPV can identify precancerous and cancerous diseases, which is especially important given their long asymptomatic course.

The main types of cervical cancer are squamous cell carcinoma and adenocarcinoma. The latter is less likely to cause bleeding because it is located higher in the cervical canal and is protected from damage during sexual intercourse.

Bleeding occurs more often with advanced than with early stages of cancer.

Another type of gynecological cancer, accompanied by bleeding after sexual intercourse, is vaginal. It accounts for 3% of malignant tumors of the female reproductive system. Most often, the tumor is located on the posterior wall of the upper third of the vagina.

Bleeding in postmenopausal women usually occurs against the background of endometrial atrophy, but 90% of patients also experience this symptom.

Finally, there are primary malignant tumors of the lower reproductive system, in which blood is released after sexual intercourse. These include, in particular, non-Hodgkin's lymphoma.

Cervicitis

This is an acute or chronic inflammation of the internal tissues of the cervix. The disease is characterized by watery or mucopurulent discharge, as well as bleeding immediately after sexual intercourse. Acute is caused by chlamydia, gonococci, trichomonas, gardnerella, mycoplasma. Chronic cervicitis usually has a non-infectious origin.

This disease must be treated promptly, since the infection can spread to the upper genital tract and lead to serious complications:

• inflammatory diseases of the pelvic organs;
• infertility;
• chronic pelvic pain;
• risk of ectopic pregnancy.

Endometritis

Inflammation of the inner lining of the uterus, which can be acute or chronic. The acute course is accompanied by the presence of microabscesses in the endometrial glands. Chronic endometritis is caused by infectious agents, foreign bodies, polyps, and fibroids. A third of patients have no apparent cause of the disease.

The pathology is characterized by complaints of dryness and burning in the vagina, pain during sexual intercourse, decreased lubrication, and discomfort in the pelvic area.

The skin disease lichen planus can also lead to bleeding.

Benign vascular neoplasms

Vascular tumors of the female reproductive organs are rare and include hemangiomas, lymphangiomas, angiomatosis, and arteriovenous malformation. Most of these formations do not manifest themselves in any way and are accidentally discovered during a gynecological examination. However, if they are superficial or large in size, mechanical damage to the vessels during sexual intercourse can cause bleeding.

Diagnostics

To clarify the reasons why blood appears from the vagina after sexual intercourse, the doctor uses the following diagnostic methods:

1. Finding out the medical history: the patient’s age, duration of bleeding, presence of diseases of the vagina and cervix, abnormal smear results, genital infections.
2. Inspect the cervix to rule out ectropion, erosion, cervical ulcer, or polyps.
3. Gynecological smear with subsequent diagnosis of sexually transmitted infections, primarily.
4. Transvaginal ultrasound to evaluate the endometrium.
5. Colposcopy if precancerous conditions or a malignant tumor of the cervix are suspected.
6. Pipel biopsy for suspected endometriosis or uterine tumor.
7. With repeated bleeding, a normal colposcopy picture and a good smear result, hysteroscopy with a biopsy of the inner layer of the uterus is indicated.

Treatment and prevention

Bleeding after sexual intercourse is not a disease, but only a symptom of the disease. Therefore, to eliminate it, it is necessary to know the cause of the pathology. Sometimes it cannot be detected, and any dangerous diseases are not diagnosed. In this case, only regular observation by a gynecologist is recommended.

If, after the examination, problems with the thyroid gland, liver, kidneys, or blood coagulation system are discovered, then the doctors’ efforts will be aimed at treating these diseases.

Conservative and other methods of treating postcoital bleeding:

• If the cause of this phenomenon is endometrial precancer, progesterone preparations are prescribed. They slow down the development of malignant cells.
• If the patient has polyps, hemangiomas or other benign tumors, they are removed surgically. Minimally invasive procedures are used, for example, cryosurgery, radioknife, laser exposure.
• If the cause of bleeding is an infection (cervicitis, nonspecific or chlamydial, gonococcal vaginitis), antibiotics must be prescribed. They are prescribed orally in a course, after which the woman again takes care of the cleanliness of the vagina.
• Bleeding during sexual intercourse during pregnancy is not dangerous if it lasts only for a short time. It is recommended to reduce the intensity of sexual activity and report discharge to your obstetrician. If you experience abdominal pain, you should consult a doctor as soon as possible, since this condition often accompanies the threat of miscarriage.
• Endometriosis can be treated with hormonal treatments or surgery.
• If there is excessive bleeding caused by sexual intercourse, curettage of the uterine cavity may be necessary, but this condition occurs extremely rarely.
• When diagnosing cervical cancer, comprehensive treatment by a gynecological oncologist is necessary. Amputation of the organ, removal of nearby lymph nodes, chemotherapy, and radiation are performed.

Preventive measures include the following:

1. Maintaining good sexual hygiene, using condoms or having contact with only one partner.
2. For vaginal dryness, use lubricants.
3. Regular medical examinations with a gynecologist with smears and cytological examination.

Contact bleeding is the bleeding that occurs in women after sexual intercourse; it is also called “postcoital.” In most cases, such bleeding does not pose any particular danger and is not a sign of the presence of any serious pathologies. They can be one-time or periodically repeated without a specific sequence. But if blood appears after each act, you should pay attention to this and visit a doctor.

Contact bleeding: causes

Several groups of causes of contact bleeding can be distinguished. The most common factors leading to bleeding after sexual intercourse are mechanical damage. For example, bleeding occurs at the first contact due to a break in the hymen. In the future, young girls may also periodically release a small amount of blood over a period of time due to careless and overly active actions of the partner.

In adult women, the appearance of contact bleeding may be due to the following reasons:

1. Lack of lubrication. In such cases, a burning sensation may be felt in the vaginal area, and sometimes a small amount of blood is released.
2. Erosion. This disease may not have any obvious symptoms. It is usually discovered during gynecological examinations. Erosion is a disruption of the epithelial layer of the mucosa on the cervix. In such cases, discharge mixed with blood may appear, and they are considered an unfavorable symptom of the disease.
3. Polyps. This concept hides a pathology that leads to the proliferation of endometrial tissue with the formation of peculiar protrusions. They can lead to bleeding and abdominal pain after menstruation or during sexual intercourse.
4. Endometriosis. It is characterized by the growth of endometrial tissue outside the uterus; it can involve the intestines, ovaries, fallopian tubes and other internal organs. Endometriosis in most cases occurs without any symptoms. The main symptoms are mild pain upon contact and spotting after contact.
5. Hyperplasia. This disease is characterized by active cell division. In some cases, hyperplasia leads to the development of tumors. Bleeding during sexual intercourse is considered an unfavorable symptom, which may be a sign of the degeneration of hyperplasia into cervical cancer.
6. Infectious diseases. The cause of contact bleeding can be sexually transmitted infections: mycoplasmosis, trichomoniasis, ureaplasmosis, chlamydia and others. Other symptoms of these pathologies are: burning, pain and itching in the vagina, ulcers, pimples, inflamed areas and blisters in the perineum and genitals, pain when urinating, mucous-bloody discharge with an unpleasant odor or admixture of pus.
7. Cervicitis. This disease is an inflammation of the cervix. It can develop in acute or blurred form. In the absence of adequate treatment, it becomes chronic. Cervicitis manifests itself as pain upon contact, mild bleeding after it, and copious discharge mixed with pus and mucus.

Contact bleeding of the cervix: causes

The causes of contact bleeding of the cervix are often precancerous and background pathologies, as well as gynecological manipulations. The most common of them are:

1. Ectopia, polyps and erosions of the cervix. These diseases are usually detected in women of childbearing age. All of them require mandatory examination, during which the epithelial layer is checked for dysplastic changes.
2. Mechanical damage and surgical procedures, such as cauterization, biopsy, disruption of the integrity of blood vessels, removal and installation of a spiral, abortion, etc.
3. Cervical cancer. The exact reasons for its development are currently unknown; it is presumably caused by changes in hormonal levels, viral infection, mechanical trauma to the cervix and other factors.

Pain and bleeding after conization are considered normal; these symptoms can persist in women for 4-5 months after surgery. During this period, the body recovers, and pain and bleeding decrease. It must be remembered that bleeding after conization should not be too heavy and should not resemble menstruation. Throughout this period, the woman will have to use sanitary pads.

In addition to bleeding, after conization, a woman may feel pain localized in the lower abdomen. They may be a consequence of the operation or be associated with non-compliance with rehabilitation rules. In case of pronounced severe pain, you should consult a specialist. He checks the possibility of re-development of the process and the integrity of the walls of the cervix. If there are no indications for repeated surgery, the woman is prescribed painkillers and antibiotics.

Treatment of contact bleeding

There are many reasons for contact bleeding. Most of them do not pose a threat to women's health. However, if the bleeding is heavy, resembles menstruation, is accompanied by pain and other obvious symptoms of pathology, you should consult a gynecologist. Treatment of contact bleeding depends on the reasons that caused it. It is better to select a course of therapy together with a specialist.

Under sexual bleeding commonly understood bleeding from the genitals(uterus, vagina, penis). There are many reasons and factors that can provoke such processes. Bleeding vary in the age of the patient, intensity, and consequences. Dangerous, first of all, with strong or frequent bleeding from the genitals blood loss. Therefore, at the first appearance of this problem, you need to contact a specialist.

Sexual bleeding in women

Sexual bleeding in women different ages can occur for various reasons, but in any case they are of two types:

- uterine bleeding;

- vaginal bleeding.

Uterine bleeding can be both natural and anomalous. There are the following causes of uterine bleeding:

- ectopic pregnancy;

Cervical erosion;

Uterine cancer;

Sexually transmitted diseases;

Taking certain medications (for example, hormonal contraceptives);

Inflammatory process in the uterus, ovaries;

Hormonal imbalances in a woman’s body;

Climax.

Bleeding is normal associated with monthly menstruation (ovum maturation), with duration of bleeding from 3 to 7 days, with a total blood loss of no more than 80 ml. But you should not forget that bleeding during menstruation, for more than 7 days and excessively heavy discharge is a reason to consult a doctor.

Concerning vaginal bleeding, then they can be provoked by the following factors:

- mechanical damage during sexual intercourse;

Enlarged condylomas (bleed from rubbing against underwear);

Disturbed microflora;

Infectious diseases;

Inflammatory processes in the vagina.

Bleeding after intercourse

If you are sexually active, you can encounter two types sexual bleeding:

- bleeding during intercourse;

- bleeding after intercourse.

But most dangerous of all bleeding during intercourse during pregnancy, which can be a signal of miscarriage, or placental abruption in the last months of pregnancy.

Bleeding after intercourse are called postcoital bleeding. If such bleeding is not intense, then they do not pose a particular threat to health at the time of their appearance. However, when they first occur, it is necessary to contact a specialist as soon as possible to identify causes of bleeding after intercourse.

Postcoital bleeding may be a symptom of diseases such as:

- chlamydia;

Gonorrhea;

Trichomoniasis;

Vaginitis;

Cervicitis;

Endometritis;

Adenomyosis;

Erosion and dysplasia of the cervix;

Cervical polyps;

Uterine cancer.

Also, some contraceptives, drugs that reduce blood clotting and other medications can also cause such bleeding.

It is worth considering separately such a case as bleeding after first intercourse.

Question of availability or no bleeding after the first sexual experience is very individual. There may be no blood due to many factors (congenital absence of the hymen, an excessively large hole in the hymen, peculiarities of the location of the blood vessels). However, there are also cases when bleeding after sexual intercourse last about a week.

Don't panic, it's normal that both absence and presence of bleeding in this situation.

Sexual bleeding in men

Sexual bleeding, contrary to popular belief, are a problem not only for women, but also for men. Main reasons bleeding from the penis are the following:

- short frenulum of the penis (as a result of tears and tears in it);

Subcutaneous rupture of the corpora cavernosa;

Damage to the scrotum;

Some sexually transmitted diseases;

Inflammatory process of the genitourinary system.

Summing up, I would like to note once again that regardless of gender at the initial appearance bleeding you should consult a doctor. Take care of yourself!

Blood after sex is a natural phenomenon only in the case of water - during defloration, loss of virginity. If sex, after which bleeding occurred, is not the first, this is a reason to worry and think about your health. So, what could be the causes of postcoital bleeding in women?

1. Injury during sex.
2. It's all about the pills.
3. Interrupted pregnancy.
4. Inflammatory process.
5. Erosions and polyps.
6. Oncological diseases.
7. Beginning of menstruation.

Injury during sex

Sex, like almost any physical activity, can cause trauma. Such injuries occur if you make love roughly or enthusiastically use various sexual toys. As a result, a woman may experience a rupture of the vaginal wall or vault, injury to the vaginal neck, etc. As a rule, such situations are accompanied by severe pain.

It's all about the pills

Taking certain medications, including birth control pills, can cause postcoital bleeding. This is a fairly rare occurrence, but it should not be ruled out. Sometimes the cause is not the pills themselves, but errors in taking them; in the case of contraceptives, it is being late or missing the next dose of the drug. A gynecologist will be able to determine the exact cause. If the bleeding is due to the pills, the doctor will recommend another drug or another way to prevent unwanted pregnancy.

Lost pregnancy

A fairly rare cause of bleeding after sex is a miscarriage. A situation is likely when, during lovemaking and active contractions of the uterus, detachment of the ovum occurs. This situation can be facilitated by hormonal disorders in a woman’s body, for example, a deficiency of the hormone progesterone.

Inflammatory process

The most likely cause of bleeding after sex is an inflammatory disease. Most often it is cervicitis or vaginitis. It should be understood that, as a rule, the inflammatory process in the female genital organs does not occur out of nowhere; it is provoked by various infections, including fungal ones. Therefore, in order to cure inflammation, it is also necessary to eliminate its root cause.

Erosions and polyps

Another common cause of bleeding after sex is erosion and polyps. They may bleed after sexual intercourse. To eliminate these causes, you should seek help from a gynecologist. The doctor will be able to cauterize the erosion and remove the polyps using a simple surgical intervention.

Oncological diseases

The most terrible cause of bleeding can be an oncological disease - cervical cancer. And it is postcoital bleeding that is practically the only symptom of this disease in the first stages. Therefore, if a woman cannot find visible causes of blood after sex, she should immediately consult a gynecologist-oncologist who will confirm or rule out such a cause.

Beginning of menstruation

It also happens that having sex coincides with the onset of menstruation. Therefore, before you panic when you see blood on the sheet, you should look at the calendar. Perhaps the cause of blood loss is banal menstruation.