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Bleeding after OB/GYN visit
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An_197124 posted:
I went in for my yearly check up on Wednesday and I had been on my period the week before and it continued on to the Monday before my appointment. After my check up I had the usual slight cramping afterwards but I have had some light bleeding since Thursday. It becomes more noticeable when I am having sex with my SO. I haven't missed any pills or anything so I'm just wondering if this is normal?
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Jane Harrison Hohner, RN, RNP responded:
Dear Anon: There are two basic culprits that can cause bleeding after sex: problems with the cervix and things that create bleeding from the uterine lining. Bleeding coming from the cervix could come from a cervical lesion---if one has had a recent normal PAP smear this is unlikely. An infection of the cervix (eg Chlamydia) can make the cervix more "friable" (easier to bleed). I rather doubt this if you are in a monogamous relationship.

In some women there is a normal enlargement of the area of glandular type tissue. These women can have bleeding when the cervix is sampled for a PAP smear. A polyp coming from the cervical canal may bleed only when the cervix is touched. Endocervical polyps of this type may be readily seen during a speculum exam--so I doubt a polyp since you just had an exam.

If the uterine lining ("endometrium") is easily destabilized, having sex can prompt spotting or breakthough bleeding. Some women will have this type of spotting if sex occurs during ovulation or right before menstrual flow is slated to begin. Women using hormonal forms of birth control (eg your birth control pills) may also have less endometrial stability.

My best GUESS, given what you have shared, is that the area sampled for a PAP smear has been the reason for the continued spotting. Typically this "fragile" glandular epithelium is a larger area in younger teen women, in pregnancy, and among birth control pill users. If the bleeding increases or persists contact the GYN who just did your exam.

Yours,
Jane


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