No matter who we are, bleeding after intercourse can be both embarrassing and uncomfortable. A healthy sex life is an important part of our lives, as this is associated with psychological and physical wellbeing and can have an extremely positive impact on our general health.
Bleeding after intercourse, also referred to as postcoital bleeding, can occur for many reasons. This may be indicative of an existing or undiagnosed health condition and can be influenced by age, sexual activity and whether or not you have had a baby.
The main causes
For young women who have regular periods, bleeding after intercourse is commonly associated with infection. It is important to have appropriate tests to exclude sexually transmitted infections (STIs) such as chlamydia which can, if left untreated, cause pelvic inflammatory disease (PID) and impaired fertility.
There are many other causes such as changes relating to the neck of the womb (cervix) as well as polyps and fibroids affecting the lining of the womb (endometrium). Both polyps and fibroids can be removed painlessly with MyoSure, a short procedure which can be completed in clinic. It is essential to have appropriate investigations such as infection screening (swabs), ultrasound scans and an assessment of the neck of the womb (colposcopy) to ensure that there are no serious underlying conditions causing postcoital bleeding. These conditions include precancerous and cancerous changes. Although uncommon, postcoital bleeding may be a sign of cervical, vaginal or endometrial cancer. This is true for all age groups, so it’s essential to have this thoroughly reviewed by an expert gynaecologist in a timely fashion.
Women of any age can experience bleeding after intercourse at any point in their lives and this is a very common phenomenon. Over 60% of those who have gone through the menopause encounter these symptoms on a regular basis. For post-menopausal women, such bleeding can be a product of genitourinary syndrome of menopause (GSM). GSM is a condition characterised by the changes the vagina goes through after the menopause as a result of declining levels of oestrogen. The vagina thins, which can lead to dryness, inflammation and irritation. GSM can result in a loss of elasticity which can make sexual intercourse very uncomfortable. These changes may cause postcoital bleeding in post-menopausal women.
Vaginal dryness, whilst common in post-menopausal women, may also be caused by factors unrelated to age such as hormonal changes associated with childbirth, breastfeeding and certain medications such as contraceptives. Vaginal dryness leaves the vagina more susceptible to discomfort and damage during intercourse and can cause postcoital bleeding. Vaginal dryness can be treated with vaginal moisturisers and lubricants, vaginal oestrogen or an intra-vaginal laser known as MonaLisa Touch®. MonaLisa Touch® is a highly effective treatment which triggers the vaginal tissues to restore the normal blood supply and to regenerate the tissues which support a normal healthy vaginal lining making the vaginal more elastic, thicker and less fragile than when the vagina has become atrophied. The vaginal tissues are also critical to supporting a healthy vaginal bacterial flora which suppresses conditions such as candidiasis (thrush) and bacterial vaginosis, the first of which may be offered as part of your first consultation.
Put your mind at ease
If you have symptoms of postcoital bleeding, it is important to be seen by an expert who can help you to find the root cause of the problem. In most cases, this is not serious and does not require major investigative procedures. However, if a more serious cause for your postcoital bleeding is found, early diagnosis and treatment will help to address the issue.
Advanced Gynaecology with Mr Francis Gardner
Many women feel anxious about their consultation with a gynaecologist. Understandably, investigative and diagnostic procedures can also be a source of great worry and concern. Mr Francis Gardner is a highly experienced Advanced Gynaecology specialist with over 25 years of experience in both gynaecology and gynaecological cancer. He has a kind and professional nature, will be able to deal with your issues sensitively and put your mind at ease. With Mr Gardner, you will experience first-class medical assessment and treatment. He also specialises in a “One Stop See and Treat” approach which offers the potential for a resolution to your problems after a single visit.
It is essential to seek medical advice if you have postcoital bleeding. Possible infections can be easily treated and serious underlying causes can be ruled out, which will put your mind at ease.
Women should not bleed after intercourse. This can be a sign of infection or something more serious, so these causes must be ruled out. Once this has been done, simple changes to contraception or hormone replacement therapy (HRT) or undergoing intra-vaginal laser treatment may resolve the issue effectively.
In order to determine the cause of this bleeding, you will be asked to describe your symptoms and asked about your general health. This will help identify potential causes.
Depending on the risk factors identified during the consultation, investigations will be carried out accordingly. Only tests which are likely to change the management of your care will be performed and you will be informed of any potential costs. These tests may include infection screening, a cervical smear test, an ultrasound assessment or clinical examinations.
The cause of the bleeding will determine the potential treatment recommended. This may include a change in contraception, the treatment of infection, the removal of abnormal cells in the cervix (colposcopy), the removal of polyps or fibroids affecting the lining of the womb (MyoSure) or laser treatment. If a more serious cause is identified, then your condition will be explained and a mutually agreed treatment plan will implemented.