Patient's question:
I recently had sex with my wife, and she always bleeds. What's going on?Doctor's answer:
Hello:Coital bleeding, also known as bleeding during sexual intercourse, is a type of contact bleeding. The other type of contact bleeding occurs during a medical examination when the cervix is touched.
There are many gynecological conditions that can cause coital bleeding. Common causes include cervical polyps, cervical erosion, submucosal uterine fibroids, post-implantation of an intrauterine device (IUD), senile vaginitis, cervical cancer, and vaginal cancer. Cervical erosion and cervical polyps are both manifestations of chronic cervical inflammation. Cervical polyps arise from chronic cervical inflammation, resulting from localized proliferation of the cervical canal mucosa, which gradually protrudes outward. The surface is covered with a layer of columnar epithelium, rich in microvessels, making it prone to bleeding upon contact. Cervical erosion is also caused by long-term inflammatory stimulation, leading to the shedding of squamous epithelium on the cervix surface. The denuded area is gradually covered by columnar epithelium that has proliferated from the cervical canal. Columnar epithelium is thin, with blood vessels and stroma beneath it, making it easy to bleed during intercourse. Women with submucosal uterine fibroids, especially those that protrude from the cervix, may experience coital bleeding due to the susceptibility of the mucosal surface to ulcers and infections. Women using intrauterine devices (IUDs) for contraception may also experience coital bleeding. This is because the IUD is a foreign object within the uterine cavity, and its mechanical pressure can cause localized endometrial damage, necrosis, and ulcers, increasing the risk of bleeding. In such cases, sexual intercourse can trigger bleeding. Early cervical cancer may also present with coital bleeding, which is why it is important to take coital bleeding seriously. Early-stage cervical cancer patients may have no obvious changes in their cervix, or the tumor may coexist with cervical erosion. The cervix in early cervical cancer is easily bleeding after touching.