Nothing kills the mood quite like seeing blood on your sheets. Unless you have your period, and therefore a clear idea of why you’d be bleeding during sex, your mind may spiral as you wonder WTF is going on.
But finding a little blood on your sheets during or even after sex (a.k.a. postcoital bleeding) is common: It affects up to 9% of women, and in most cases it’s no biggie—especially if things got rough. “Generally, it’s not a cause for concern,” Jacques Moritz, MD, an ob-gyn and medical director of Tia Clinic in New York City, tells SELF.
That said, there are important clues that can help you figure out what’s causing you to bleed—like where you are in your cycle and how often you notice blood—and whether sex-related bleeding could be a sign of a health condition. Below, ob-gyns explain why you might experience some spotting during sex and when blood on your bed warrants a check-in with your doctor.
Is it normal to bleed during or after sex?
If you haven’t yet hit menopause, sporadic, light bleeding after sex is usually nothing to worry about. The truth is, there are a handful of things that can make you more prone to bleeding during your reproductive years.
For starters, you may have a cervix that’s especially sensitive to touch (which is more common in young people) or be approaching your period. “If you’re close to the period, two or three days before, [some bleeding is] kind of to be expected,” Dr. Moritz says. “The uterine lining gets so thick, and when the uterus moves around a lot during intercourse, some cells will come off.”
Simply taking hormonal birth control can also make you more susceptible to bleeding a bit during vaginal intercourse—especially if the sex is particularly enthusiastic. The reason: Some contraceptives, like the pill, may cause vaginal dryness, and when you’re lacking moisture down there, added friction can cause the skin to break and bleed.
But there are some cases where the blood can be a sign of a larger issue. If bleeding is heavy, persists well after your post-sex pee, or happens every time you have sex, it can be a sign of a more serious issue like a tear, fibroid or polyp, or, rarely, cancer.
Bleeding during sex becomes less normal once you hit menopause. During your reproductive years, there are many likely (and very common) explanations for it. But when you’re no longer menstruating or taking birth control, the list of potential causes of bleeding dwindles, and there’s a greater chance that something more serious—like endometrial or cervical cancer—is to blame. So your doctor will want to know about any bleeding before or after sex (or in general) ASAP so they can decide if more testing is needed. Yes, even if it happened only one time and was short-lived.
That’s not to say bleeding postmenopause is always due to cancer. The more likely scenario is that you’re dealing with vaginal dryness, Sherry A. Ross, MD, an ob-gyn in Santa Monica, California, and author of She-ology: The Definitive Guide to Women’s Intimate Health. Period, tells SELF. Vaginal dryness in this age group (thanks, hormones!) can cause tears and sometimes bleeding after sex, Dr. Ross explains. A quick visit with your ob-gyn can help you determine what’s going on and ensure that you detect any health issues early on.
Can hitting the cervix cause bleeding?
The short answer: Yes, definitely. The long answer: During sex, your partner’s penis, finger, or sex toy may hit your cervix, the narrow passage that sits at the back of your vaginal canal and connects it to the uterus. For some people, this feels pleasurable—but it can also be painful (and a little bit bloody), especially if the penetration was rough or deep.
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