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Bleeding during sex
rene1977 posted:
Hi I am 35 y/o female and have recently starting bleeding this year only dduring sex. I have no pain and am lubricated. I am on loestren 24 and use condoms. I have had a normal pap smear and was told my cervix looked visually good. I was put on metrogel because I refused cryo for a lets see treatment...I am still bleeding during sex and now they want to go ahead with the cryo. I am not sure this is the "cure" for my problem. My cervix doensn't bleed when just touched so I don't see how this will fix it. There is a lot of talk about this on the internet but no solutions.
Jane Harrison Hohner, RN, RNP responded:
Dear rene: 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 from Chlamydia) can make the cervix more "friable" (easier to bleed). 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. Yet you mention that the cervix does not bleed when touched. 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.

If the uterine lining is easily destabilized, having sex can prompt spotting or breakthrough 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 may also have less stability of the uterine lining. Infections (eg Gonorrhea, Chlamydia) can destabilize the uterine lining causing erratic bleeding and bleeding after sex. Also, endometrial polyps or uterine fibroids can create a focus for unstable uterine lining.

rene1977, given what you have shared, if you have had normal PAP smears (and continue to bleed despite the Metrogel), my best GUESS is that your birth control may be playing a part. Your specific brand of birth control was advertised by the manufacturer as one that could keep the lining of the uterus so thin that the woman would not have her "pill period". The only down side is that a very thin lining can also be easier to destabilize and produce spottng after heavy exercise or sex.

Now rene, I have not seen your cervix or your PAP smear history. Your GYN has all this information so it may be that there is a strong possibility for your spotting to be coming from the cervix--hence the colposcopy and suggestion for cryo. Perhaps you do have a "normal" enlargement of the area of glandular tissue on the face of the cervix as this is commonly treated with cryo.

Bottom line, you are asking all the right questions, but only your examining GYN can give you the most accurate diagnosis. PLEASE go back and ask your questions to them. It is OK to be direct and ask if they think it is a problem with the cervix or with the lining of the uterus.

In Support,

PS If you get a definitive answer, would you be so kind as to write us back on your original post? That way many other women could be benefited by your experience.

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