Bleeding during sexual intercourse can be caused by the rupture of the hymen during the first intercourse, vaginal trauma during intimate contact or even the onset of menstruation, and in most cases it does not require specific treatment.
However, this can also be caused by candidiasis, sexually transmitted infections or endometriosis, which are usually accompanied by other symptoms such as discharge, pain or burning when urinating, or pelvic pain, for example.
In these cases, a gynecologist should be consulted to identify the cause of bleeding during intercourse and thus recommend the most appropriate treatment.
Main causes
The main causes of bleeding during sexual intercourse are:
1. Hymen rupture
Bleeding during intercourse can occur due to the rupture of the hymen, which is a membrane that covers the entrance to the vagina.
This bleeding can occur during the first vaginal sexual intercourse, later or even not at all.
What to do: The rupture of the hymen does not require treatment, unless the girl or woman presents intense bleeding, which must be evaluated by a gynecologist. Furthermore, before having sexual intercourse for the first time, it is important to consult a gynecologist in order to obtain guidance and the best contraceptive method.
2. Trauma during intimate contact
Trauma during intimate contact, such as having very intense sexual intercourse, having sex several times in a row or not having enough lubrication, can cause injuries to the vaginal canal.
Furthermore, trauma during intimate anal contact can also cause bleeding during anal intercourse.
What to do: If the bleeding is very intense or painful, you should consult a gynecologist or coloproctologist for an evaluation and indication of treatments, if necessary.
3. Vaginal dryness
Vaginal dryness can occur due to lack of stimulation, decreased libido, menopause, breastfeeding or even the use of medication, which can cause irritation in the vaginal canal due to friction during intercourse, resulting in bleeding.
What to do: You can use a water-based intimate lubricant in the genital region before initiating sexual contact. However, vaginal dryness should always be evaluated by a gynecologist, to identify its cause, and indicate the best treatment that can be done with hormone replacement, for example.
4. Dropping of menstruation
Bleeding during intercourse can also occur due to the decline of menstruation, as orgasm can cause contractions of the uterus, and promote menstruation.
What to do: No treatment is needed for bleeding caused by menstruation. However, it is always important to be monitored by a gynecologist.
5. Candidiasis
Vaginal candidiasis is an infection caused by the fungus Candida albicans, leading to symptoms such as whitish discharge, similar to cottage cheese, intense itching in the genital region and redness.
This type of infection can cause bleeding and pain during sexual intercourse, as it causes inflammation of the vagina and vaginal canal, which become more sensitive to the friction of sexual intercourse, resulting in small traumas or cracks.
What to do: you should consult your gynecologist to start treatment with antifungal ointments or tablets, such as miconazole or terconazole, for example. See how candidiasis is treated.
6. Bacterial vaginosis
Bacterial vaginosis is an infection in the vagina caused by bacteria of the genus Gardnerella sp., which, when not treated properly, can progress to pelvic inflammatory disease (PID).
PID affects the uterus, ovaries and fallopian tubes, and can cause bleeding during or after intercourse, in addition to symptoms such as foul-smelling discharge, pain during intimate contact or when urinating, fever and general malaise, for example.
What to do: treatment should be carried out using antibiotics recommended by the gynecologist, such as clindamycin or doxycycline, for example, and it is also recommended to avoid intimate contact during treatment.
7. Sexually transmitted infections
Bleeding during intercourse can also occur due to sexually transmitted infections (STIs), such as trichomoniasis, chlamydia or gonorrhea.
Other symptoms of STIs are itching, a burning sensation in the intimate area, pain and burning sensation when urinating, green, yellow or gray discharge usually with a bad smell, or redness in the genital area, for example.
What to do: You must follow the guidance of your gynecologist, who can indicate treatment according to the microorganism responsible for the STI, with the use of antibiotics being most often recommended. See how STIs are treated.
8. Endometriosis
Endometriosis is the abnormal growth of endometrial cells outside the uterus, which can adhere to the intestines, ovaries, fallopian tubes or bladder, as well as the back of the vagina or lower part of the uterus, and cause bleeding during or after intercourse. intimate contact.
Other symptoms that may indicate endometriosis are intense cramps during menstruation, heavy menstruation or frequent pelvic pain.
What to do: Endometriosis must be treated with guidance from a gynecologist, who may recommend the use of contraceptives or placement of a hormonal IUD, anti-inflammatories to relieve cramps, or in more serious cases, surgery. See all treatment options for endometriosis.
9. Vaginismus
Vaginismus is the involuntary contraction of a woman’s pelvic floor muscles, preventing vaginal penetration during intimate contact or causing pain during intercourse.
This condition can cause greater fragility of the vaginal walls, and result in bleeding during or after intercourse.
Vaginismus can happen at any stage of a woman’s life and can have physical or psychological causes, such as fear of becoming pregnant, sexual abuse or urinary tract diseases, for example.
What to do: You should consult a gynecologist to have vaginismus diagnosed. This way, the doctor can indicate the most appropriate treatment that can be done with cognitive-behavioral therapy, pelvic exercises or the use of medication.
10. Cervical ectopia
Cervical ectopia, or cervical ectropion, is the growth of cells from the inner part of the cervix to the outside of the cervix in the inner region of the vaginal canal.
This condition can make the cervix more sensitive, resulting in the rupture of small blood vessels during intimate contact, and cause bright red bleeding during intercourse.
Other symptoms of cervical ectopia are vaginal discharge, bleeding outside of the menstrual period, pelvic pain or pain during intimate contact.
What to do: Cervical ectopia does not always require treatment, but if a woman presents many symptoms, the gynecologist may recommend the use of hormonal contraceptives. In some cases, it may be necessary to cauterize the tissue out of the cervix.
11. Menopausal genitourinary syndrome
Menopausal genitourinary syndrome, also called vulvovaginal atrophy, is vaginal inflammation caused by a decrease in estrogen in the body, leaving the walls of the vagina thinner, drier and less elastic.
This syndrome is characterized by vaginal dryness, irritation and flaccidity of the mucosa, which can result in pain or bleeding during intercourse, in addition to other symptoms, such as loss of sexual desire or urinary incontinence, for example.
What to do: The gynecologist may recommend the use of vaginal estrogen in the form of cream, gel or tablets or non-hormonal lubricants in the form of creams or vaginal ovules, to reduce symptoms and discomfort.
Could bleeding during intercourse be pregnancy?
Bleeding during intercourse could be pregnancy, especially when it is early in pregnancy, due to implantation bleeding, which occurs when the embryo is implanted in the uterus.
However, there is very little bleeding and can be seen as light or pink spots. Know how to identify all the symptoms of pregnancy.
When to go to the gynecologist
It is important to consult a gynecologist in the presence of heavy vaginal bleeding or if it is accompanied by symptoms, such as:
- Pain during intimate contact;
- Whitish, green, yellow or gray discharge, or with a bad smell;
- Pelvic pain;
- Pain or burning when urinating;
- Redness or swelling in the genital region;
- Fever and general malaise.
Therefore, the gynecologist must perform a gynecological examination and request additional tests, in order to identify the cause of bleeding during intercourse and, thus, indicate the most appropriate treatment, if necessary.
Make an appointment with a gynecologist in the nearest region:
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