August 23, 2006

Q&A: Vaginal Bleeding During And After Sex

There are many possible reasons for bleeding that occurs during or after intercourse.

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Question: I had sex over the weekend. I was very intoxicated, but I was very clear that I wanted to participate. I woke up to see blood on the sheets and at the time I couldn’t figure out where the blood came from. I was not in pain nor was I expecting my period. The last time I had intercourse before this was about a month. I have gone longer without sex before and did not bleed. This is not my first time having sex, nor is it my first partner. What could have happened? Is it possible that I finally had my hymen break? Or is it possible that he penetrated too deeply? Is it an allergic reaction to the condom or the lube? I am very embarrassed by this and very confused.

Many Possible Reasons

There are many possible reasons for bleeding during sex or bleeding that occurs after intercourse.

Since you have previously had intercourse before, it is unlikely that you “broke” your hymen (the hymen is a thin layer of tissue that partially covers the vaginal entrance and is filled with blood vessels, thus causing bleeding in some women when it first tears due to penetration).

The hymen may tear from various types of penetration including intercourse, vaginal fingering, or insertion of a sex toy. The hymen does not “grow back” if you have not had sex in a long time, as is sometimes mistakenly believed.

Vaginal or Vulvar Tearing

It is possible that you experienced some vaginal or vulvar (outside parts of the genitals) tearing during intercourse. If it was a small amount of blood, it is unlikely that you would have experienced much pain.

If there was a large amount of blood on the sheets, then one would usually expect some pain or discomfort, though perhaps the alcohol dulled the pain at the time and it was resolved the next morning. We know that alcohol lowers inhibition, and it may actually work against your physical arousal, making intercourse more difficult and leading to tearing.

When women have tearing around the entrance of the vagina, or just inside, healthcare providers sometimes prescribe specific antibiotic ointments in order to reduce the risk of developing an infection.

Therefore if you think you may have tearing inside, you might check in with your healthcare provider so that he or she can exam you (tearing, by the way, happens to many women at one time or another).

Why Might Tearing Occur?

Why might tearing occur? It often occurs during rough penetration or when a woman is not well lubricated ( e.g., if you did not spend much time in foreplay before having sex or if sex went on for a long time, both of which can occur while intoxicated as couples sometimes jump into sex and a man’s orgasm may be delayed or not occur at all, thus making sex take longer than usual).

Though women can react from a hypersensitivity or allergy to condoms or lubricant, these are unlikely to cause such bleeding. Another possibility is that one of you may have had a cut elsewhere (i.e., on your knee or hand). That happens sometimes too, with couples mistaking it for vaginal bleeding.

A Fairly Common Occurrence

Whatever the cause, this is actually a fairly common occurrence and nothing to be embarrassed about (though we understand that it can feel embarrassing at the time). It sounds like you have learned a bit more about how you feel about sex, drinking, and mixing the two, as well as communicating with a sexual partner.

It is common for men and women to find it difficult to discuss sexuality (particularly when they are relatively new to sex), and it can feel even more challenging to discuss sexual topics if you don’t know each other very well.

Because vaginal bleeding during sex happens to most women at some point, many couples take it in stride and move on. If you feel like you want to discuss it, you might start by letting your partner know that it feels awkward for you to talk about it, but that you’d feel better if you could.

  • Just chiming in to add that in some cases, bleeding after sex may be a sign of cervical infection, possibly due to a sexually transmitted infection. If you haven't been tested recently, it's a good idea to check in with a trusted care provider (check out my fabulous employer if you're in the Seattle, WA area). Also, certain types of birth control, like a progesterone-releasing IUD, can make the uterine lining (endometrium) attach more loosely to the uterine wall, meaning it can be jarred loose during intercourse.

  • abyrnes4

    Thank you so much for posting this. it explains my situation perfectly and makes me feel much better.
    I just encountered the same thing two days ago and have been terrified. I was really experiencing pain down their yesterday but nothing really today (a little dryness). I am still bleeding a little bit off and on. I haven't had intercourse since my last pap ( which came out negative) so I don't think I have any STDs.I think I might go an visit a doctor anyway to avoid any infection.

  • Janet b njovu

    Thank you for the extra information about the progesterone- releasing IUD. I think this is what is happening in my case because i had this type of birth control for 8 years. I started experiencing some discomfort during sex and eventually started noticing small blood stains just after sex. Although this only started happening a month before i had it removed and the discomfort seems to get worse each time i have sex now. I will get checked at the earliest convinient..thank you very much enlightening me.