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Post-Coital Bleeding
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nolabonbon29 posted:
I am seriously worried right now because of all of the possible causes that google has been giving me and I would like I real answer from somebody who knows. Last night, after having sex, I went to the bathroom and noticed bright red blood when I wiped. Today it was only a little bit of brown discharge. This wasn't the first time I have had sex, but it is the first time that my husband has been able to go all the way in. It only hurt a little bit during intercourse. I am on Tri-Previfem for birth control and my period is supposed to start in about 3 days. Can anyone tell me what's going on? Because google keeps telling me that I either have cancer or an STD, which both frighten me very much. Thank you so much, Bonnie.
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An_142427 responded:
Nola- What you described sounds like simple vaginal or cervical irritation to me. Sometimes when sex is vigorous, deep or perhaps you are just a little dry or sensitive down there, the vaginal walls or cervix can get inflamed and bleed a bit. If the bleeding was only present while wiping, and is already receding I wouldn't worry too much. If this happens after all sex there could be an underlying infection causing the inflammation. If the bleeding continues after a few days, or you have any pain, I would worry and see a doc.
 
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Jane Harrison Hohner, RN, RNP responded:
Dear Bonnie: 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 easier to bleed. Yet if you are in a monogamous relationship this is not going to apply to you! 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.

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 a less stable uterine lining. Polyps of the lining, or uterine fibroids, can create a focus for unstable uterine lining. These tend to be more common in midlife women If a woman has a history of missed periods, her uterine lining may be very thickened. In that situation spotting can represent small amounts of the lining being shed---just off the top layer.

Other, much less common causes for bleeding include small tears in vaginal tissue. If the spotting is after the first time having intercourse there can be spotting from tissues at the vaginal opening.

In your specific case Bonnie, the culprit MIGHT be an unstable lining from being on birth control pills and having it be close to your "Pill period". Having complete penetration MIGHT have contributed some spotting as well.

Given the multiple causes of bleeding after sex, one should go see a GYN if the spotting persists or is recurrent.

Yours,
Jane


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