Blood loss after sexual intercourse: what does it depend on?

 The 3 main cases of bleeding , the possible causes, and remedies:

 


Where does the blood loss come from?

 

In the majority of cases, these losses are caused by a cervical polyp, an ectropion, or a " sore "; however, if you want to consider all the potential causes, it is advisable to determine where exactly the blood loss originates.

 

Case 1 - The leak comes from the entrance to the vagina

Blood losses after intercourse can be caused by damage to the hymen or the residues if it is not the first intercourse. They can also depend on abrasions of the vaginal mucosa that occur during intercourse. If blood loss after intercourse takes on a haemorrhagic characteristic that does not tend to resolve spontaneously, it is usually due to a laceration which almost always requires surgical suture.

 

Case 2 - The leak comes from the cervix

 

In this case the causes could be:

  1. "sore" or rather an ectopy or an ectropion of the cervix , which consists of an eversion, a displacement towards the outside of the endocervical mucosa, that is, that which is normally positioned inside the canal of the neck of the uterus. uterus.
    This mucosa can be particularly "fragile" and can easily undergo inflammatory processes, and sometimes the trauma of sexual intercourse can cause lesions and therefore the appearance of bleeding
  2. polyp of the cervix , a neoformation that is generally benign and richly vascularized which, during the mechanical trauma of intercourse, can cause bleeding
  3. Precancerous lesions or cervical cancers , often related to a viral HPV infection

Case 3 - The leak comes from inside the uterus

 

In this case the losses may be due to either organic problems such as endometrial polyps (i.e. present inside the uterus), thickening or hyperplasia of the endometrium (the mucous membrane that lines the inside of the uterus), or uterine fibroids , or endometrial tumors.

 

However, it can also depend on hormonal causes , for example due to changes in the thyroid gland, adrenal gland, increased prolactin, microcystic ovary, etc., or because you are taking hormonal contraceptives (pill or patch for example) and episodes of spotting due to either low dose, or because there have been intake errors (e.g., forgetfulness).

 

Keep in mind, however, that for this type of organic or hormonal causes, blood loss generally occurs NOT ONLY after sexual intercourse, BUT ALSO OUTSIDE OF THIS EVENIENCE BETWEEN ONE CYCLE AND ANOTHER.

 

What should i do if bleeding occurs after sexual intercourse?

It is important to bear in mind that this symptom should never be underestimated, and that therefore a gynecological examination must be made to be able to establish the exact cause. In addition to the visit, a colposcopy may be required to carefully evaluate the cervix with a possible biopsy in case of suspicious lesions, a pap test and possibly an HPV Dna test if alterations from HPV viruses are detected. A suprapubic or transvaginal pelvic ultrasound could be useful to carefully evaluate the state of the uterus and ovaries and in the case of endouterine pathologies such as polyps, hyperplasia or fibroids a further diagnostic examination with a hysteroscopy may be necessary.

 

What are the remedies, the therapies for these bleeding after intercourse?

 

The therapies will obviously be different and specific depending on the diagnosis made by the gynecologist.

  • In case of infections we will proceed with targeted therapies that may be of various types depending on the responsible microorganism and to be administered vaginally in the form of eggs, creams, douches, possibly also associated with oral therapies.
  • In case of vaginal dryness , based on the triggering cause, it is possible to prescribe for example lubricating and moisturizing creams or vaginal gels or estrogen in case of hypoestrogenism, change of the type of estroprogenistic pill, etc.
  • In the case of cervical " sores " through the visit and colposcopy it will be assessed whether it is appropriate to treat them or to keep them under observation only, depending on the extent, any lesions and any associated vaginal infections.
  • In case of cervical polyps or endometrial polyps or submucosal fibroids, it will be necessary to remove them hysteroscopically.
  • In case of hormonal imbalances, the therapy will be different and specific depending on the type of hormonal alteration.
  • In case of alterations from HPV infection , the therapies will be evaluated case by case according to the type of lesion found.

Advice and insights In conclusion,

we can therefore say that it is important not to underestimate this symptom and always carry out a gynecological check- up in case of blood loss after sexual intercourse, for an early diagnosis and for a correct and decisive type of therapy.


Vincenza. “Perdite Di Sangue Dopo I Rapporti Sessuali: Quali Cause?” MEDICITALIA.it, www.medicitalia.it/blog/ginecologia-e-ostetricia/2672-perdite-di-sangue-dopo-i-rapporti-sessuali-da-che-dipendono.html. Accessed 5 Nov. 2022.

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