Bleeding Between Periods or After Sex

Bleeding between periods, also known as intermenstrual bleeding, and bleeding after sex, also known as postcoital bleeding, are symptoms that can be caused by a variety of factors. These symptoms can be alarming, but in many cases, they are not a cause for concern.

Possible Causes

• Hormonal Changes: Fluctuations in hormone levels, particularly estrogen and progesterone, can cause bleeding between periods or after sex. This is common during puberty, menopause, or with the use of hormonal birth control.
• Cervical Polyps: These are growths on the cervix that can cause bleeding after sex or between periods. They are usually benign and can be removed if necessary.
• Uterine Fibroids: Non-cancerous growths in the uterus can cause heavy or irregular menstrual bleeding, including bleeding between periods or after sex.
• Endometrial Hyperplasia: A condition where the lining of the uterus grows too thick, leading to abnormal bleeding. This can be caused by hormonal imbalances or other factors.
• Cervicitis: Inflammation of the cervix, often caused by infection, can cause bleeding after sex or between periods.
• Sexually Transmitted Infections (STIs): Certain STIs, such as chlamydia or gonorrhea, can cause bleeding after sex or between periods.
• Cancer: Although rare, cervical, uterine, or ovarian cancer can cause abnormal vaginal bleeding, including bleeding between periods or after sex.

Other Factors

• Birth Control: Certain types of birth control, such as the intrauterine device (IUD), can cause irregular bleeding or spotting.
• Pregnancy: Implantation of a fertilized egg into the uterus can cause light bleeding or spotting.
• Thyroid Disorders: Certain thyroid conditions, such as hypothyroidism or hyperthyroidism, can affect menstrual cycles and cause abnormal bleeding.

What to Do

If you experience bleeding between periods or after sex, it is essential to consult a healthcare provider for proper evaluation and diagnosis. Your provider may perform a physical exam, take a medical history, and order diagnostic tests, such as:

• Pelvic exam
• Pap test
• Ultrasound
• Endometrial biopsy
• STI testing

Treatment will depend on the underlying cause of the bleeding. In some cases, no treatment may be necessary, while in other cases, medication, surgery, or other interventions may be required.