Bleeding After Sex

Bleeding after sex during menopause, known as postcoital bleeding, causes vaginal dryness, thinning, and fragility of the tissues, making you prone to irritation and bleeding.

Introduction

Bleeding after sex, known as postcoital bleeding, can be a concerning symptom during menopause and perimenopause. This bleeding is often related to hormonal changes, particularly the decline in oestrogen levels. Oestrogen helps maintain the health and thickness of the vaginal lining. As oestrogen levels decrease, the vaginal tissues can become thin, dry, and more fragile, making them prone to irritation and bleeding during intercourse.

Other potential causes of postcoital bleeding include vaginal or cervical atrophy, vaginal infections, polyps, or more serious conditions like cervical or endometrial cancer. In some cases, bleeding may also be caused by trauma or microtears from insufficient lubrication.

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What Are the Typical Signs?

Signs of bleeding after sex may vary in intensity and duration but typically include:

  • Light spotting or small amounts of blood on tissue paper or underwear after intercourse
  • Bright red blood immediately following sex
  • Discomfort or pain during or after intercourse
  • Dryness or irritation in the vaginal area

The amount of bleeding can range from minimal spotting to more noticeable bleeding. It’s important to note any additional symptoms, such as unusual discharge or pelvic pain, which may require medical attention.

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Tips on How to Manage or Reduce Symptoms

Lifestyle Tips:

  1. Use Lubricants: Water-based, fragrance-free lubricants can reduce friction and prevent trauma to the vaginal tissues during sex.
  2. Vaginal Moisturizers: Regular use of vaginal moisturizers can improve vaginal hydration and tissue health.
  3. Foreplay and Communication: Spend more time on foreplay to increase natural lubrication and communicate with your partner about what feels comfortable.
  4. Gentle Intercourse: Avoid aggressive or rough intercourse, and consider using positions that reduce pressure on sensitive areas.
  5. Stay Hydrated and Maintain Vaginal Health: Drink plenty of water and avoid irritants like scented soaps or douches that can further dry or irritate the vaginal tissues.
  6. Pelvic Floor Exercises (Kegels): These can improve blood flow to the pelvic area and support overall vaginal health.
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Diagnostic Tests and Treatment Options:

  • Pelvic Exam: To assess the health of your vaginal and cervical tissues.
  • Pap Smear: To check for cervical cell abnormalities.
  • Ultrasound: To examine the uterus and ovaries for potential causes of bleeding.
  • Vaginal Oestrogen Therapy: Low-dose oestrogen creams, tablets, or rings may be recommended to improve vaginal tissue health.
  • Treating Infections: If an infection is the cause, antibiotics or antifungal treatments may be prescribed.
  • Removal of Polyps: If polyps are found, they may need to be removed.

Conclusion

Bleeding after sex during menopause and perimenopause is often due to hormonal changes that cause vaginal dryness and thinning. While it can be alarming, many cases are manageable with lifestyle changes and treatments to improve vaginal health. It is important to seek medical attention if bleeding persists or is accompanied by other symptoms to rule out more serious conditions.

Bleeding After Sex FAQ's

Light, occasional bleeding may occur due to vaginal dryness and thinning tissues. However, persistent or heavy bleeding should be evaluated by a healthcare provider to rule out any underlying conditions.

Yes, vaginal oestrogen therapy can help restore the thickness and elasticity of vaginal tissues, reducing the likelihood of bleeding. It’s important to discuss the risks and benefits with your doctor.

While bleeding can sometimes indicate more serious conditions like cervical or endometrial cancer, it is not always the case. It’s important to have any unusual bleeding evaluated to ensure proper diagnosis and treatment.