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Bleeding after sex

by Dr Sarah Brewer

question
Every time my boyfriend and I have sex, I bleed. There was no bleeding the first time we had sex, it only started happening after the second time. I read that it could be a sign of an STI? What could cause this bleeding?

answer
Do get this checked out, as bleeding after sex can be due to a number of different problems. In many cases, no obvious cause may be found but infections such as chlamydia and pelvic inflammatory disease should not be ruled out.

Another possible cause of bleeding between periods could be a hormone imbalance. If you use the oral contraceptive pill, you could be experiencing breakthrough bleeding. If so, you will usually be advised to use an additional method of contraception and if it continues for more than two or three cycles, you may be given a higher dose of the Pill.

A cervical erosion (more properly known as an ectropion) can cause bleeding between periods and occurs when the delicate cells lining the cervical canal also cover an area on the outer cervix. This forms a red, velvety area that bleeds easily when touched. This is a normal result of oestrogen stimulation and is common in women on the Pill and during pregnancy.

Sometimes, bleeding after sex is due to a cervical polyp - a fragile, fleshy growth that can protrude through the cervical opening on a stalk.

The possibilities of miscarriage or ectopic pregnancy need to be explored. Any woman who notices any bleeding between periods or after sex should seek medical advice - even if it is only slight spotting.
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