Postcoital Bleeding

Postcoital bleeding, also known as postcoital spotting, is vaginal bleeding that occurs after sexual intercourse.

Causes

• Cervical polyps or cervical cancer: Abnormal cell growth on the cervix can cause bleeding after sex.
• Cervicitis: Inflammation of the cervix, often caused by a sexually transmitted infection (STI), can lead to postcoital bleeding.
• Endometrial polyps or endometrial cancer: Growths or abnormal cell growth in the lining of the uterus can cause bleeding after sex.
• Vaginal dryness or atrophy: Decreased estrogen levels, often during menopause, can cause vaginal dryness and bleeding after sex.
• Pelvic inflammatory disease (PID): A bacterial infection that causes inflammation of the reproductive organs can lead to postcoital bleeding.
• Sexually transmitted infections (STIs): Certain STIs, such as chlamydia or gonorrhea, can cause cervical inflammation and bleeding after sex.

Risk Factors

• Age: Women over 40 are more likely to experience postcoital bleeding due to decreased estrogen levels and increased risk of cervical cancer.
• History of STIs: Women with a history of STIs are at higher risk of developing conditions that cause postcoital bleeding.
• Smoking: Smoking can increase the risk of cervical cancer and other conditions that cause postcoital bleeding.
• Weakened immune system: Women with weakened immune systems, such as those with HIV/AIDS, are more susceptible to infections that can cause postcoital bleeding.

Symptoms

• Vaginal bleeding after sex
• Spotting or light bleeding
• Heavy or prolonged bleeding
• Pelvic pain or discomfort during or after sex
• Abnormal vaginal discharge

Diagnosis

Diagnosis of postcoital bleeding typically involves a physical exam, medical history, and laboratory tests, such as:

• Pelvic exam
• Pap test
• Colposcopy
• Blood tests for STIs or other infections
• Imaging tests, such as ultrasound or MRI, to rule out other conditions

Treatment

Treatment of postcoital bleeding depends on the underlying cause and may involve:

• Antibiotics for STIs or other infections
• Hormone replacement therapy (HRT) for vaginal dryness or atrophy
• Surgery to remove cervical polyps or other growths
• Cancer treatment, such as chemotherapy or radiation therapy, if cancer is present

Prevention

To reduce the risk of postcoital bleeding, women can:

• Practice safe sex to prevent STIs
• Get regular Pap tests and pelvic exams
• Maintain good vaginal health through proper hygiene and lubrication during sex
• Avoid smoking and maintain a healthy lifestyle