I’m having pain after sex
I am having a problem. When I am having sexual intercourse, I have this pain in my belly bottom and when I am finished I see blood. Can you please tell me what that could be and if I need medical help?
Post-coital bleeding or bleeding after sexual activity is significant and should be properly investigated. It may be seen when there is an infection of the cervix or uterus or vagina. If infection is severe, then the tissues will bleed when irritated by sexual activity. This infection is usually sexually transmitted.
In some cases, the infection may spread through the cervix down the fallopian tubes and causes the tubes and the pelvis to become inflamed resulting in Pelvic Inflammatory Disease (PID). This causes pain during and after intercourse. This may develop into a chronic problem and cause damage to the fallopian tubes leading to blockage and subsequent infertility.
Cervical polyps, precancerous changes and also cancer of the cervix may also present with bleeding after sexual activity. Polyps may be from the lining of the uterus and may originate directly from the cervix. If a polyp is present, this should be removed and sent for testing to determine the cause and to rule out cancer.
A cervical smear (Pap Smear) is extremely important once you have post-coital bleeding. This will determine the presence of a precancerous growth or cancer of the cervix. A pap smear can also pick up inflammation of the cervix. However, a swab taken from the cervix is usually a better means of determining the cause of the infection.
Your partner will also need evaluation to see if he has a sexually transmitted infection. It is important to consult your gynaecologist or family doctor who will do the appropriate evaluation. Take your partner along for evaluation too, since both of you will need treatment to prevent recurrence of an infection as the underlying course. Consider using a condom until you receive proper evaluation. It would also be a good idea to do screening for other sexually active infections such as syphilis and Human Immunodeficiency Virus (HIV).
Best wishes.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions and comments via email to allwoman@jamaicaobserver.com or fax to 968-2025. We regret that we cannot supply personal answers.
