If You’re Bleeding During Sex, This Might Be Why

Sometimes, your vagina bleeds. Of course, you know this, as you bleed during your period. But you might also experience spotting between periods or while you’re pregnant. And if you’re pregnant, you may have noticed some implantation bleeding when the fertilized egg implanted itself in your uterine lining. While bleeding during sex might sound alarming, there are many non-serious possible explanations. Of course, there are some more serious explanations, too.

According to one study, around six percent of menstruating women experience non-period-related bleeding during or after sex each year, with higher numbers for postmenopausal women. If you notice consistent bleeding during sex, especially if it’s accompanied by pain or other symptoms, head to your doctor to get things checked out. Here are some reasons why you might bleed during sex.

If you notice some bleeding during sex, particularly if you’re having rough sex or not using lube, you may have scraped your vagina. This can happen during penis-in-vagina sex, during fingering, and even during masturbation. "Most of the time, these scratches or cuts are very small and heal on their own within a few days. Very rarely, a scratch or cut inside of the vagina may need medical attention to help it heal and reduce the risk of an infection," June Gupta, MSN, WHNP-BC, associate director of medical standards at Planned Parenthood Federation of America, previously told Refinery29. To reduce the likelihood of this happening, next time, add lube.

You may have also hit your cervix during sex, which can cause bleeding. If your cervix experiences any kind of trauma (which can be as simple as an unexpected bump), “you’re going to have actual bleeding, instead of under-the-surface bleeding,” Meryl Kahan, MD, an OB/GYN who practices in New York, previously told Refinery29. If you have an IUD, the string can irritate your cervix during sex and, yes, cause bleeding.

If you’re having period sex, you probably know it. But having sex near the start of your period may actually make your period begin a day or two early, particularly if you orgasm. And if you’re having sex shortly after your period ended, the motion may have “knocked out” some remaining period blood. Periods — they can be weird!

Spotting is common during pregnancy because of the hormonal changes your body is going through. Pregnancy hormones “can impact the cervix and can change the actual type of cells that are on the outer surface of the cervix into the type that is more prone to bleeding and more prone to injury from trauma,” Dr. Kahan previously told Refinery29. While spotting during pregnancy is common, it’s best to check in with your doctor just to make sure everything is going well.

Your estrogen levels drop after giving birth and while breastfeeding. Lower estrogen levels mean that you’ll likely experience vaginal dryness and be more prone to bleeding during sex. Using lube will help reduce the risk of bleeding, and also make vaginal sex feel better.

The hormonal changes associated with menopause also make vaginal bleeding common, including during or after sex. As your body produces less estrogen, you produce less natural lubrication and your vaginal tissues become thinner. Lube will help, and your doctor may prescribe treatment such as an estrogen cream.

Bleeding during sex may also indicate that you stretched or tore your hymen. The hymen, also called the vaginal corona, is thin, fleshy tissue near the vaginal opening. Some people have more hymenal tissue than others, and some people have none at all. Sex, including fingering, using sex toys, and masturbating, can stretch or tear the hymen, as can all sorts of non-sexual activities such as putting in a tampon or playing sports.

Vaginal bleeding is a sign of some infections, including a yeast infection, bacterial vaginosis, and some STIs, including chlamydia and syphilis. Bleeding may be accompanied by other symptoms, including a change in odor, discharge, and itchiness or burning. If untreated, vaginal infections can cause cervicitis, an inflammation of the cervix, or pelvic inflammatory disease, an infection of the reproductive organs.

Uterine fibroids are non-cancerous growths in and around the uterus. If they're large, they can cause pain during sex, and sometimes bleeding as well. Fibroids can be treated with uterine fibroid embolization, hormone therapy, radio frequency ablation (RFA), or surgery; your doctor can advise on the best treatment for you.

Bleeding during sex is also a symptom of other health conditions, including cervical, uterine, or vaginal cancer; cervical polyps; cervical ectropion; and endometriosis. If you’re regularly bleeding during sex, or if bleeding is accompanied by pain or any other symptoms, head to an OB/GYN to figure out what’s up. And if you're at all worried, it's a good idea to see a healthcare provider, even if you only bled once.