Patient's question:
Got married for two or three years without taking any contraceptive measures, but haven't been able to get pregnant. I was wondering if having sex after the last day of menstruation can lead to a bacterial infection?Doctor's answer:
Hello! First of all, I wish you a speedy recovery! I'd like to discuss the issue of "coitus during menstruation."The consequences of coitus during menstruation can only be summarized as "temporary pleasure, endless trouble." During the ovulation period, if a woman does not conceive, the endometrium will naturally shed, resulting in continuous bleeding for 5–7 days. During this time, the physiological barrier of the reproductive tract is weakened. If sexual intercourse occurs, it is easy to damage the reproductive tract and cause bacterial infections, gradually leading to gynecological diseases such as cervicitis and pelvic inflammatory disease. Moreover, it is not ruled out that ovulation may still occur during menstruation, making contraception unreliable. According to relevant experts, coitus during menstruation may also the root cause of female infertility and must be.
1) Immunological infertility accounts for about 10–30%
After married couples of childbearing age maintain normal sexual activity for two years without using contraception and remain childless, they may suffer from infertility. Among these cases, situations where sperm fails to combine with eggs due to male autoantibodies (ASAb) or female autoantibodies are classified as immunological infertility. Experts believe that about 10–30% of infertility cases are related to immunological factors.
The causes of immunological infertility are usually traced to both men and women. Under normal circumstances, when the immune defense mechanism of the reproductive system is intact, men generally do not produce ASAb. However, when the blood-testis barrier is damaged by surgery or trauma, sperm is exposed to the immune system, potentially leading to the production of ASAb.
The factors contributing to female ASAb production include individual immune differences, the lack of immune-suppressing molecules in semen, as well as reproductive tract infections, inflammation, and sexual intercourse under conditions of reproductive tract mucosal damage. Experts report that in cases of unexplained female infertility, about 80% of patients tested positive for ASAb in blood tests. Once this antibody is produced in a woman's body, it causes sperm to clump together and lose mobility during intercourse, preventing successful fertilization.
2) Damaged reproductive tract: Sperm becomes the "number one enemy"
It is reported that the vaginal and cervical mucosa of women have immune functions. If sperm enters the reproductive tract during inflammation or damage, it is recognized as the "number one enemy." Macrophages with the ability to clear "foreign invaders" enter the reproductive tract to engulf and digest sperm cells. Meanwhile, antigens carried by sperm activate lymphocytes, while changes in the permeability of the reproductive tract mucosa trigger an immune response.
The result of this series of "actions" is the presence of high concentrations of ASAb in cervical mucus, making it extremely difficult for sperm to travel through the female reproductive tract and reach the specific location where it can combine with an egg.
Experts indicate that during menstruation or when experiencing uterine bleeding or endometritis, if sexual intercourse is insisted upon due to damaged reproductive tract mucosa, it will provide easy access for sperm and its antigens to enter the bloodstream and come into contact with immune cells, further increasing the likelihood of ASAb production.
3) Coitus during menstruation: Harmful to both parties
Some may ask, "If coitus during menstruation leads to infertility this time, won't it be fine to wait until after her period next time?" However, the reality is far from what one wishes. It is reported that during intercourse with endometritis or abnormal reproductive tracts, if a woman has an allergic reaction to seminal antigens, even after the reproductive tract recovers, a so-called "secondary immune response" may occur, causing the body to continuously produce ASAb, making it difficult to stop.
Some young men may feel that when their wives have their periods, it lasts nearly a week or even longer, and they cannot resist their desires during this time. In sexual activity, women often find it hard to refuse their partners' requests. Experts point out that men should exercise self-discipline during this period. Coitus during menstruation can lead to gynecological diseases and immunological infertility, causing far-reaching effects on future sexual happiness and family life. Additionally, a satisfying sexual life requires good physical health and a positive mood. During menstruation, women lose a significant amount of blood and are relatively weak, making it difficult to enjoy the experience. Even if they proceed, the discomfort afterward may leave psychological shadows.
4) Patients can be classified into four types for dietary and nutritional care
If ASAb is detected through immunological tests, Western medicine typically recommends using condoms during intercourse to isolate sperm and gradually eliminate the antibody. However, if the antibody persists, this measure is of little significance. In traditional Chinese medicine, infertility is believed to be related to "qi stagnation and blood stasis," emphasizing "promoting qi flow, activating blood, resolving stagnation, and tonifying the kidneys." In recent years, it has further been proposed that "clearing heat, draining dampness, and detoxifying" are also necessary.
Experts report that female patients can generally be classified into four types for treatment: kidney deficiency, liver depression, blood stasis, and damp-heat. Kidney deficiency is characterized by lower back pain, frequent nighttime urination, weakness in the knees and head dizziness. Liver depression manifests as irritability, depression, costal pain, and bitter taste in the mouth. Blood stasis is indicated by menstrual pain, lower abdominal pain, fixed pain points that intensify under pressure, and dark purple, tongue with astringent pulse. Damp-heat is characterized by reduced urination, abdominal pain, and thick, greasy white tongue coating.
On the premise of first treating reproductive tract inflammation, dietary and nutritional care can be adopted for treatment. It is recommended to boil soup with ingredients such as scorpions, red beans, kelp, and tianqi, with additional herbs based on individual constitution. For qi deficiency, red ginseng can be added; for yin deficiency, Dendrobium candidum can be added; for qi-yin deficiency, Panax quinquefolius can be added; and for spleen deficiency, white atractylodes and Poria can be added.
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