Dear Dr Mitchell,
A few days ago, at day nine of my cycle, I started bleeding after moderate sex with my husband. It lasted a day, and was very light. A few days before that I had cramps similar to menstrual cramps. What could be the cause of this? When I Googled the symptoms it could be anything from ovulation bleeding, to implantation bleeding, to cancer of the cervix. It was a very scary experience!
Bleeding after sexual activity is a serious sign that should not be ignored. It may be due to one of several factors. This includes cancer of the cervix, vagina or uterus, cervical polyps, a prolapsed uterine fibroid, inflammation of the cervix (cervicitis), and cervical trauma or vaginal trauma.
It is important to have a proper evaluation done by your gynaecologist or general practitioner. This should include a Pap smear, endocervical swab, a high vaginal swab, and a pelvic ultrasound.
A pelvic examination can be very useful in detecting polyps on the cervix or in the vagina and a prolapsed fibroid coming from the cavity of the uterus. If there is significant inflammation of the cervix this can also be detected. Abrasions or lacerations in the vagina or on the cervix can also be detected. A pelvic ultrasound can be done to assess the lining of the uterus to determine if there is excessive thickening or polyps in the uterus. If the lining is found to be abnormal then a biopsy can be done to rule out cancer of the uterus or hormonal imbalance.
If the underlying problem is due to an infection then both you and your partner will need treatment to reduce recurrence. Cervical polyps or prolapsed fibroids can also be removed and sent for testing. You should consider vaccination to prevent cervical cancer if this has not been already undertaken. The age range for vaccination is age 10 – 65 years.
It is important for you to have the problem fully resolved before resuming sexual activity.
Consult your doctor who will advise you further.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to firstname.lastname@example.org; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 968-2025. All responses are published. Dr Mitchell cannot provide personal responses.
The contents of this article are for informational purposes only, and must not be relied upon as an alternative to medical advice or treatment from your own doctor.