Postcoital Bleeding: Causes, Evaluation & Treatment | MyDocsy

Bleeding after intercourse can be benign or a sign of cervical or uterine pathology. A structured approach to causes, red flags, tests, and management including ectropion, infection, polyps, dryness, and abnormal Pap follow-up.

Understanding Postcoital Bleeding

Bleeding after intercourse is never something to ignore. Causes may be benign (cervical ectropion, infection, polyp) but can also indicate cervical or uterine pathology. MyDocsy ensures structured evaluation without unnecessary testing.

Common Benign Causes

Cervical Ectropion

  • Bleeding after sex
  • Sometimes increased discharge
  • Seen in young women or hormonal contraception users
  • Usually painless
  • Managed conservatively unless persistent

Cervicitis

  • Bleeding after sex
  • Discharge
  • Burning urination
  • Pelvic discomfort

Cervical Polyps

  • Recurrent spotting
  • Bleeding after sex
  • Visible on speculum exam
  • Usually removed in clinic

Vaginal Dryness / Atrophy

  • Perimenopause, menopause, postpartum/breastfeeding
  • Fragile tissue tears easily, leading to spotting

Trauma

  • Rough intercourse
  • Inadequate lubrication
  • Vaginal fissures
  • Especially common when dryness is present

Red Flags — Get Evaluated Promptly

Recurrent bleeding after sex, bleeding with pelvic pain or foul discharge, postmenopausal bleeding, visible lumps, or enlarged groin nodes require structured evaluation.

Tests That Usually Matter

Pap smear if due/abnormal, HPV testing if indicated, swabs for infection, pelvic ultrasound if bleeding is irregular or heavy, colposcopy if Pap/HPV abnormal or lesion suspicious.

Treatment Options (Cause-Based)

Cervical ectropion: reassurance or local treatment if persistent. Infection: targeted antibiotics, partner treatment, follow-up. Cervical polyp: simple removal, histopathology confirmation. Dryness: vaginal moisturizers, local estrogen, pelvic floor relaxation. Abnormal Pap/suspicious lesion: colposcopy, biopsy if needed, structured cervical care pathway.

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