Patient's question:
Main symptoms: Bleeding during intercourse Onset time: Half a year Laboratory test results: Pelvic inflammationDoctor's answer:
Main Causes of Sexual Bleeding Sexual bleeding is a common symptom of gynecological diseases, with the following main causes:1. Cervicitis (erosion). 90% of women after marriage suffer from cervicitis. Cervicitis is classified into mild, moderate, and severe degrees based on the extent of cervical erosion. In women with moderate or severe cervical erosion, friction between the male penis and the cervix during sexual intercourse can cause injury and bleeding. Because the bleeding is minimal and does not immediately flow out, it accumulates in the vagina, changing color from fresh to old. The next day, the blood appears dark red when it is expelled.
2. Cervical polyps. Chronic inflammation of the cervix can lead to cervical polyps. These are small, pedunculated granular tissues that grow at the cervix opening, resembling sprouts of soybean, and can grow as large as a finger. Due to their fragile texture, they bleed easily upon contact, so bleeding may occur after sexual intercourse. This type of bleeding is usually bright red.
3. Cervical cancer. Post-coital bleeding is one of the earliest symptoms of cervical cancer. Due to the presence of numerous small blood vessels and fragile tissue in the tumor, capillaries rupture and bleed during intercourse. If the cancer progresses further, bleeding becomes more likely.
4. Endometriosis. In some cases, endometrial tissue grows on the cervix, forming bluish-purple nodules. During intercourse, if these nodules are touched, bleeding may occur. The bleeding is usually minimal and dark red, and abdominal pain may also occur after intercourse.
5. Pelvic inflammatory disease. Inflammation of the pelvic region can cause pelvic congestion. If the endometrium is congested and edematous, sexual intercourse may lead to bleeding from the congested tissue. However, this is rare.
For women experiencing sexual bleeding, the first step is to identify the underlying cause. If the bleeding is due to local organic lesions of the external genitalia, treating the lesion will resolve the bleeding. For example, sexual bleeding caused by vulvar ulcers, eczema, or herpes should first be treated with antibiotics to eliminate inflammation, and the eczema or herpes should be cured, allowing the bleeding to naturally subside. If the bleeding is caused by trichomoniasis, metronidazole should be used to treat the infection, and bleeding will naturally stop once the trichomoniasis is cured.
If sexual bleeding is due to improper intercourse, couples should learn about sexual health together, be considerate of each other, cooperate fully, and adopt appropriate sexual positions and techniques. Women should relax mentally, avoid tension and depression, and eliminate unnecessary worries. Men should provide ample foreplay to stimulate the woman’s arousal. During intercourse, movements should be gentle, avoiding roughness or insertion into the vagina. Postmenopausal women may apply lubricant to the external genitalia during intercourse to improve vaginal lubrication and prevent atrophy. Sexual activity should be appropriately restricted, and intercourse during menstruation is prohibited. Women over 40 experiencing sexual bleeding should be alert to the possibility of malignant genital lesions.