Is Vaginal Bleeding After Sex a Sign of Cancer?

This page is for anyone who has had vaginal bleeding after sex and wonders if it could be cancer. It covers the usual causes, when to see a doctor, and what the exam involves.

The cervix is the lower, narrow end of the womb. It sits at the top of the vagina, and it gets touched during sex.

MedlinePlus lists causes of bleeding between periods. Several sit right there:

• Injury or disease of the vaginal opening, caused by intercourse, infection, a polyp, genital warts, an ulcer or varicose veins.
• Inflammation or infection of the cervix or the womb.
• Cervical or womb polyps, and fibroids.
• Changes in hormone levels.
• Vaginal dryness from lack of estrogen after menopause.

MedlinePlus says most causes of bleeding between periods or after menopause are benign and can be easily treated. It also says that sometimes the cause is cancer or pre-cancer, which is why any unusual bleeding should be checked.

NCI and the American Cancer Society both list bleeding after sex among the symptoms of cervical cancer. The others on their lists include:

• Bleeding between periods, after menopause, or periods that are heavier or longer than usual.
• Unusual vaginal discharge, which may be watery, have a strong smell, or contain blood.
• Pain during sex.
• Pain in the pelvis.

The American Cancer Society says that if you have any of these, you should see a health care professional right away. The National Institute on Aging also lists bleeding or spotting after sex as a reason to see your doctor.

Both agencies add a note worth hearing. These symptoms can be caused by many conditions other than cervical cancer. NCI says the only way to know is to see a health professional.

Keep a short record: the dates, how much, and whether there was pain, discharge or a smell. Note whether it happens every time or only once in a while.

MedlinePlus suggests keeping track of how many pads or tampons are used, so the amount of bleeding can be judged. It also says to contact your provider if abnormal bleeding comes with pelvic pain, tiredness or dizziness.

Heavy bleeding is handled differently.

• MedlinePlus says to contact your provider right away if bleeding is very heavy.
• Heavy bleeding can cause shock. Signs include feeling dizzy or faint, passing out, pale or clammy skin, a racing pulse, confusion or shortness of breath. MedlinePlus says to call 911 for any signs of shock.

Cervical screening changes what this symptom means, so bring the dates.

NCI explains that screening uses a Pap test, an HPV test, or both. It looks for cell changes in the cervix that could turn into cancer if left untreated. Someone screened recently with a normal result is in a different position from someone who has never been screened or is years overdue. NCI also notes that cervical cancer found early is usually easier to treat.

Bring your last screening date and result if you have it. If you cannot remember, say so.

The National Institute on Aging says menopause is confirmed one year after the final period. If you have not had a period for more than a year, bleeding after sex counts as postmenopausal bleeding. That is checked on its own terms.

MedlinePlus says to contact your provider about any bleeding after menopause. It says the risk of cancer rises to about 10% in women with bleeding after menopause.

Our page on postmenopausal bleeding covers the timing and the tests.

One combination overrides everything above.

MedlinePlus explains that a pregnancy outside the womb, called an ectopic pregnancy, can break open and bleed. The signs include severe, sharp, sudden pain low in the belly. They also include fainting or feeling faint, shoulder pain, and strong pressure in the rectum. MedlinePlus says this needs emergency medical help. Call 911.

Short of that, you might be pregnant and have unusual bleeding or pain low in the belly. MedlinePlus says to contact your provider. Other early signs it lists are mild cramping on one side of the pelvis and a missed period.

MedlinePlus says a careful exam is most often the best way to find where bleeding comes from. It can be done even while you are bleeding. The exam includes a pelvic exam, where a speculum is gently placed so the cervix can be seen.

Tests that may follow include:

• a Pap test.
• a swab to check for infection.
• a pregnancy test.
• a pelvic ultrasound.
• colposcopy, a closer look at the cervix, with a biopsy if needed.

It may feel uncomfortable. Tell the clinician if something hurts.

• NCI — Cervical Cancer Symptoms
• NCI — Cervical Cancer Screening
• American Cancer Society — Signs and Symptoms of Cervical Cancer
• MedlinePlus — Vaginal bleeding between periods
• MedlinePlus — Ectopic pregnancy
• MedlinePlus — Shock
• National Institute on Aging — What Is Menopause?