November 20, 2008

Q&A: Does Vaginal Bleeding After Sex Reduce Pregnancy Risk?

Vaginal bleeding after having sex for the first time is fairly common for women. What about the second time? Is it related to pregnancy risk?

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Question: I had sex last night for the second time. I woke up in the morning to find that I had bled – it was more a watery patchy pinkness on the sheets. I was embarrassed and confused because the first time I had sex I bled and I didn’t think it would happen the second time, if my hymen was already broken. Why did this happen? Also we didn’t use a condom as we were both very drunk. He said that I won’t get pregnant since I bled from sex. Is this true? I’m worried and scared.

Many women experience vaginal bleeding during the first few times that they had sex. When the hymen tears, it does not necessarily tear all at once. It may continue to tear gradually over time, and sexual experience, so it is indeed common to experience slight bleeding on the second or even third occurrence of sex.

That said, if you continue to noticed bleeding or if you have any other vaginal symptoms such as irritation, itching, or burning, you should check in with a healthcare provider to rule out other health issues, including sexually transmissible infections, or STIs. All women who are sexually active, even if just once or twice, should have a gynecological exam anyway as a means of caring for their reproductive health. So if you haven’t already done so, now may be a good time to make an appointment for a gynecological exam.

This is particularly true now that you had unprotected sex with a partner. It is not true that you cannot get pregnant from sex if you bleed. In fact, a woman can absolutely become pregnant from unprotected sex, even if it is her first or second time having sex, and even if she bleeds. The blood, for example, does not “wash out” the semen.

If this just recently happened, you might contact your healthcare provider immediately for information about emergency contraception (also called the “morning after pill”) which can help to reduce the risk of pregnancy if taken within 5 days of unprotected sex. It is most effective when taken very soon, such as within 3 days, of unprotected intercourse.

As you know, many women and men find that alcohol can lower a person’s inhibitions and affect their judgment, which can contribute to them doing things that they might not normally do. If you did not want to have sex with this person, or if you did not want to have unprotected sex, but did so because you were drunk, then perhaps this is an opportunity to re-evaluate your choices regarding drinking and sexuality. Some women and men make pacts with their close friends that at least one of them will remain completely sober and will not let the others do things that they say they don’t want to do. In the future, perhaps you and your friends can discuss ways of keeping each other safe if you plan to drink.

To learn more about women’s sexual health, including issues related to safer sex, pregnancy risk and the relationship between alcohol and sex, you might read Our Bodies, Ourselves by the Boston Women’s Health Book Collective.