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How to Know When Bleeding During Sex Is NBD and When It’s a Problem

Sex isn’t exactly the most pristine activity, thanks to all the bodily fluids involved. It’s inevitable that things are going to get a little wet and messy. But bleeding during sex (or postcoital bleeding, meaning bleeding after sex) isn’t always something you should ignore and just write off as part of the process. The thing is, vaginal bleeding during sex is sometimes NBD, especially if it’s a one-off. But other times, especially when repeated, it can be a sign of a health problem—like a pelvic infection or, in some cases, even cancer—that needs to be addressed, according to the Mayo Clinic. (Note: When we discuss bleeding during and after sex in this article, we’re talking about vaginal intercourse specifically here. Anal is a topic for another day.)

A few factors can help you determine if your bleeding during sex or postcoital bleeding is cause for concern, like where you are in your cycle, how much blood there is, how often it happens, if you had really rough sex, and if you’re postmenopausal. Below, we asked ob-gyns to break down what can cause spotting or bleeding during and after sex, and when it’s worth looping in your doctor.

Is it normal to bleed during or after sex? | Can hitting the cervix cause bleeding? | Is bleeding during sex a sign of pregnancy? | Can bleeding during sex be a sign of a tear? | Other potential causes of bleeding during sex and postcoital bleeding | When to see a doctor for bleeding during or after sex

Is it normal to bleed during or after sex?

Generally, if you haven’t yet hit menopause, light bleeding after sex on rare occasions is probably nothing to worry about, the Mayo Clinic says.

The key words here are “rare” and “light.” Because as much as we’d like to tell you to just never worry about bleeding during sex—we all have enough worries as it is!—sometimes it is definitely worth paying attention to and seeking medical answers for. But if you see a little bit of light spotting during or after sex one time, then it goes away, chances are you can chalk it up to just another body thing. 

There are a few common reasons behind light bleeding after sex. “If it’s close to the period, two or three days before, [some bleeding is] kind of to be expected,” Jacques Moritz, M.D., ob-gyn and medical director of Tia Clinic in New York City, tells SELF. “The uterine lining gets so thick, and when the uterus moves around a lot during intercourse, some cells will come off.” This is especially true if you’re having rougher sex. So, bleeding during sex or postcoital bleeding in this kind of circumstance, where there’s a really clear explanation, usually isn’t something that counts as a cause for concern. 

But, as with pretty much anything when it comes to your health, listen to your instincts. If you feel like you have a good explanation for what’s causing your spotting or bleeding during or after sex, but you’re still concerned or want some peace of mind, definitely make an appointment with a care provider just to be sure.

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Can hitting the cervix cause bleeding?

The short answer: Yes, definitely. The long answer: The cervix tends to be more sensitive at certain times of the month—and some people just have sensitive cervixes in general—which can lead to spotting after sex.

If you notice some bloody discharge after sex and you’re in the middle of your cycle, it’s not necessarily a problem, as long as, again, it happens very rarely. “During ovulation, [your cervix] can be more sensitive, causing spotting during intercourse,” Sherry A. Ross, M.D., an ob-gyn in Santa Monica, California, and author of She-ology: The Definitive Guide to Women’s Intimate Health. Period., tells SELF. This can be even more common for people taking hormonal birth control, she adds.

Bleeding during or after sex is also more likely if the sex is rough and/or penetration is very deep, not only hitting the cervix once but over and over again.

Dr. Moritz also adds that younger people tend to have more sensitive cervices that can bleed easily from something like rough sex or even a procedure like a Pap smear or pelvic exam.

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Is bleeding during sex a sign of pregnancy?

Pregnancy is another thing that makes the cervix sensitive and can lead to a little bleeding during or after sex, Dr. Moritz says. For what it’s worth, light spotting during early pregnancy is common, according to the American College of Obstetricians and Gynecologists (ACOG), even though it can be really scary to actually experience (here’s how to know when bleeding during pregnancy is something you should call your ob-gyn about). And sometimes, that bleeding happens right after sex because pregnancy causes you to develop more blood vessels in areas like your cervix.

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