Post-coital bleeding is the medical term for bleeding after intercourse and it is not normal. Post-coital bleeding can be caused from an infection, inflammation, or lesion on the cervix. It can also be caused from problems with the endomtrium, the inside lining of the uterus. The evaluation of post-coital bleeding may include a history and physical exam, cultures for infection, a colposcopy, and an ultrasound. The treatment will depend on the cause of the bleeding.
The cervix is built to withstand the force that is placed against it during intercourse. If the cervix bleeds after sex something is not functioning properly. An infection of the cervix can cause inflammation and increased blood flow to the cervix and may present as bleeding after sex. There are many things that can cause inflammation of the cervix, chlamydia and gonorrhea are two common infections that may present this way. Cultures of the cervix will usually be done during an evaluation for post-coital bleeding. If an infection is found, antibiotics will usually clear up the problem.
A lesion on the cervix can also cause bleeding after intercourse. A cervical polyp is a fairly common finding in women with post-coital bleeding. Polyps are usually benign but do have the potential to be pre-cancerous or rarely, even cancer. It is very easy to remove a cervical polyp in the office. The procedure is quick and painless for most women. Cervical dysplasia is another example of a lesion that can cause post-coital bleeding. Colposcopy is the procedure that can evaluate for dysplasia. Colposcopy involves using a speculum like with a pap smear and looking at the cervix through a microscope. Abnormal areas can be biopsied to make a diagnosis. If dysplasia is present a LEEP cone biopsy will usually cure the problem although other techniques are sometimes used.
The inside lining of the uterus can also be responsible for bleeding after sex. An infection of the endometrium, a polyp, or a hyperplasia can sometimes be to blame. An ultrasound can often help to diagnose problems in the uterus. An endometrial biopsy may also be necessary. If a problem with the endometrium is causing the bleeding, a D&C or sometimes hormonal therapy may treat the problem.