Postcoital bleeding refers to genital bleeding after intercourse. Obviously, there are many different ways to have sex. When talking about postcoital bleeding, we are referring to bleeding that happens after sex when vaginal penetration is involved. That means postcoital bleeding can happen after vaginal penetration by a penis, a dildo, a partner’s finger you get the point.

Anatomically, the two parts of your body that can bleed from the friction or relative trauma of vaginal sex are your vagina and your cervix.

The most common causes for vaginal bleeding after sex both start in the cervix, which is the narrow, tube-like end of the uterus that opens into the vagina.

1. Birth control side effect

One of the main perks of hormonal birth control is its ability to regulate your cycle. But “any type of hormonal contraceptive can lead to spotting after intercourse,” you would notice this when you start a new pill, for example; it can take a few months for your body to adjust to it.

But something else could be going on. Hormonal contraception “can occasionally cause significant atrophy, or drying up, of the vagina, and as a result intercourse can cause tearing and some bleeding,”

2. Infections

Any type of infection can cause inflammation of vaginal tissues, making them more vulnerable to damage. These commonly include yeast infections, pelvic inflammatory disease, cervicitis, vaginitis, and sexually transmitted infections, such as chlamydia and gonorrhea.

3. Vaginal dryness

Dryness is among the most common causes of postcoital bleeding. When the skin is dry it becomes extremely vulnerable to damage. Mucus-producing tissues, such as those in the vagina, are especially vulnerable.

4. Polyps

Polyps are noncancerous growths. They’re sometimes found on the cervix or in the endometrial lining of the uterus. A polyp dangles like a round pendant on a chain. Polyp movement can irritate the surrounding tissue and cause bleeding from small blood vessels.

5. Vaginal tearing

Sex, especially vigorous sex, can cause small cuts or scrapes to the vagina. This is more likely to happen if you have vaginal dryness due to menopause, breastfeeding, or other factors.

6. Cancer

Irregular vaginal bleeding, including bleeding after sex, is a common symptom of cervical or vaginal cancer. In fact, it was the symptom for which 11 percent of women diagnosed with cervical cancer first sought treatment. Postmenopausal bleeding can also be a symptom of uterine cancer.

Determining how to prevent postcoital bleeding depends on what has caused bleeding for you in the past. For most women, using water- or silicone-based lubricants will help prevent bleeding caused by vaginal dryness and friction during sex. If you are using condoms, an oil-based lubricant can damage it. Water-based lubricants are recommended.

It may also help to take sex slowly, and to stop if you feel pain. Using vaginal moisturizers regularly can help keep the area moist and make you feel comfortable.

If your symptoms of postcoital bleeding are related to a medical condition, you can talk to your doctor about the best options to prevent future episodes. Take care to stick to the treatment plan recommended by your doctor.

If you’re having postcoital bleeding, you may also be experiencing abnormal uterine bleeding that isn’t related to sex. Also speak with a doctor if postcoital bleeding is accompanied by additional symptoms, including:

• vaginal burning or itching
• abnormal discharge
• intense abdominal pain
• nausea, vomiting, or lack of appetite
• stinging or burning when urinating or during intercourse
• lower back pain
• unexplained fatigue and weakness
• headaches or lightheadedness
• abnormally pale skin
• bladder or bowel symptoms

Bleeding after sex is usually a symptom of another condition. Many of these, such as infections and polyps, are treatable. Occasional spotting after sex generally clears up on its own without medical care. If you’re postmenopausal, promptly notify your doctor about any postcoital bleeding.