After a hysterectomy, what's going on with post-coital bleeding?

Patient's question:

Patient Gender: Li Qian
Detailed Condition and Purpose of Consultation: Hello expert; I had a hysterectomy in July this year due to uterine fibroids. It has been 4 months since the surgery. After sexual intercourse with my husband, there has been a small amount of bleeding. Is this normal? Or is there another problem? Thank you!

Doctor's answer:

Vaginal bleeding during intercourse first requires identifying the cause. If the bleeding is due to organic lesions in the female external genitalia, treating the local condition will resolve the bleeding. For instance, if the bleeding is caused by conditions such as vulvar ulcers, eczema, or herpes, antibiotics should be used to reduce inflammation, and the eczema or herpes should be cured, allowing the bleeding to naturally subside. If the bleeding is due to trichomoniasis, metronidazole should be used to treat the infection, and once the trichomoniasis is cured, the bleeding will naturally stop.
If the bleeding is caused by improper intercourse, both partners should learn about sexual health, show mutual understanding, and cooperate fully. The woman should relax mentally, and the man should be gentle during intercourse, avoiding roughness. Postmenopausal women may apply a lubricant to the vulva during intercourse to improve vaginal moisture and prevent atrophy. Sexual activity should be appropriately restricted, and intercourse is prohibited during menstruation. Women over 40 with vaginal bleeding during intercourse should be cautious of possible malignant lesions in the reproductive organs.