Advice from a doctor: Bleeding after sex during pregnancy

Advice From a Doctor: Bleeding After Sex During Pregnancy
Medically reviewed by Dr. Marsha Dunkely

Overview

Vaginal bleeding experienced after sex during pregnancy can be alarming. Our physician, Dr. Cherilyn  Cecchini, discusses what may lead to this symptom and what you need to know if you find yourself in this situation.  

There are many reasons why a woman may experience vaginal bleeding after sex when she is pregnant. Bleeding during the first trimester can occur in up to 15 to 25% of pregnancies. One study determined that spotting is most common during the sixth and seventh weeks of pregnancy. The American Pregnancy Association noted that sex during a normal pregnancy is not risky for miscarriage. Although vaginal bleeding after sex while pregnant is common and often not a sign of a severe issue, it is important to check in with your healthcare provider if you experience any amount of vaginal bleeding when pregnant. 

What are the causes of bleeding after Sex during pregnancy

There can be different reasons for bleeding after sex during pregnancy; you should not take that for granted. Always consult with a doctor to rule out the possibility of anything serious.

Implantation Bleeding

Implantation bleeding is one common cause of vaginal bleeding that women may experience at the onset of pregnancy. 

It is thought that implantation bleeding occurs when the fertilized egg attaches itself to the lining of the uterus. Although common, some women may not experience implantation bleeding or see any spotting early in the pregnancy. Both experiences are considered normal. 

Implantation bleeding is usually light and only lasts a few days. It may be noticeably lighter than a woman’s normal menstrual period.  Implantation bleeding generally occurs around 10 to 14 days after ovulation, when women expect their menstrual period. Given this, some women may mistake implantation bleeding for a lighter menstrual period, so be sure to keep this in mind if there is a chance you may be pregnant and experience blood flow that differs from your typical menstrual period around this time.

Vaginal bleeding during pregnancy may need medical attention. Seek professional advice if you have noticed bleeding or spotting during pregnancy.

Bleeding Caused by Changes to the Cervix

The cervix is the circular muscle band separating the uterus from the vagina. The cervix experiences many changes during pregnancy. 

When a woman conceives, the cervix moves and remains in a higher position in the vagina—increased blood flow to the cervix when a pregnant woman leads to a softer texture and increased sensitivity. Changes to the cervix may be why a pregnant woman experiences irritation and vaginal bleeding after sex. 

Bleeding Caused by Infection

Vaginal bleeding experienced at any time when a woman is pregnant may be a sign of infection. Certain infections cause the cervix to become irritated or inflamed and vulnerable to bleeding, including:

  • Yeast infections
  • Bacterial Vaginosis
  • Trichomoniasis
  • Gonorrhea
  • Chlamydia
  • Herpes

Bleeding caused by ectopic pregnancy

In an uncomplicated pregnancy, the fertilized egg travels through the fallopian tubes and implants in the lining of the uterus. With an ectopic pregnancy, the fertilized egg implants outside the uterus, most often in the fallopian tube. In rare cases, the egg may implant in an ovary or the cervix.

A quick, accurate, timely diagnosis of ectopic pregnancy is imperative since this condition may be life-threatening. If the fertilized egg implants in one of the fallopian tubes, it may cause the fallopian tube to rupture as it grows 

An ectopic pregnancy may result after damage to the fallopian tubes, which  is sometimes caused by: 

  • Pelvic inflammatory disease
  • Endometriosis
  • Smoking
  • Prior surgery on your fallopian tubes

Fertility treatments, such as in vitro fertilization

Bleeding caused by placenta previa

The placenta is an organ that forms during pregnancy to provide oxygen and nutrients from the mother’s bloodstream to the developing baby. In most pregnancies, the placenta implants at the top or on the side of the uterus, away from the opening of the cervix.

Placenta previa occurs when the placenta implants at the bottom of the uterus and partially or wholly covers the cervix. 

Vaginal bleeding experienced by a pregnant woman after 20 weeks gestation may indicate placenta previa. Sexual intercourse may cause vaginal bleeding in women with placenta previa throughout the pregnancy. Since the placenta is implanted near the bottom of the uterus, it may start to separate and bleed as it stretches to accommodate the growing baby.

Consult an online doctor for advice on safe sex during pregnancy.

Bleeding caused by placental abruption

Placental abruption occurs when the placenta detaches from the uterus early in the pregnancy before the time of delivery. It commonly occurs around 25 weeks of pregnancy in roughly 1% of pregnancies. Placental abruption may lead to spontaneous vaginal bleeding in pregnant women unrelated to sexual intercourse or after sexual intercourse. 

Also read: Your Doctors Online Helped Me Through My High-Risk Pregnancy

Bleeding Caused by a Subchorionic Hematoma

Subchorionic hematoma, also known as subchorionic bleeding, occurs when blood forms between the placenta and the uterus. It may lead to light spotting, or it may cause no symptoms, and it happens most often during the first trimester of pregnancy. Some subchorionic hematomas are diagnosed during routine ultrasounds. It typically resolves on its own without the need for any medical or surgical intervention. (https://rxreviewz.com/)  

Also Read: Sex positions during pregnancy 

Bleeding After Sex Caused by Miscarriage

Vaginal bleeding when pregnant may indicate a woman experiencing a miscarriage or loss of pregnancy. Bleeding due to a miscarriage is often heavy and may last several days. 

Signs and symptoms of a miscarriage also include:

  • Cramping
  • Loss of pregnancy symptoms such as nausea
  • White-pink mucus
  • Passing of clots of tissue-like material
  • Cramps
  • Lower back pain

Bleeding by Trimester 

Vaginal bleeding experienced during the first trimester of pregnancy is more common than bleeding experienced in the second or third trimesters. 

Light bleeding in the second trimester may be caused by irritation or inflammation of the cervix, whereas heavy bleeding may related to the placenta.

Vaginal bleeding during the third r trimester may signify preterm labor, full-term labor, placenta previa, or placental abruption. Certain infections may lead to vaginal bleeding at any time throughout the pregnancy. 

Contact your healthcare provider immediately if you experience any vaginal bleeding during your pregnancy. Noting the amount of blood, the color of the blood, and the duration of the bleeding help determine what may be the cause of the bleeding.

Treatment

The first action to take is to abstain from intercourse, especially in the case of a more severe condition such as placenta abruption. Furthermore, your doctor may recommend pelvic rest, avoiding inserting anything in the vagina until further notice, or antibiotics in case of an infection.

Depending on the condition, stage, and severity, the following treatment may be required:

  • Ectopic pregnancy: medical or surgical treatment.
  • Vaginal lacerations: In case of profuse bleeding, surgical treatment and blood transfusion may be necessary.
  • Placental abruption or placenta previa: Cesarean delivery and a blood transfusion may be necessary.

Prevention

Abstinence from sex may be the only prevention until or unless your doctor has cleared you for sexual activity. Depending on the severity and condition, changing sexual positions or decreasing the intensity of sexual activity may help prevent bleeding as well.

When to consult a doctor

If you experience any unusual bleeding, spotting, or other unusual symptoms during pregnancy, particularly after sex, you should try seeking professional advice immediately to rule out the possibility of anything serious.

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FAQs about bleeding after sex during pregnancy

Is bleeding after sex while pregnant normal?

Any amount of vaginal bleeding after sex can raise a concern. Some amount of bleeding or spotting that subsides soon after is considered normal. However, if the bleeding is consistent, heavy, or accompanied by lower abdominal pain, it is advisable to inform your doctor or visit the ER. 

Is sexual activity safe during pregnancy?

Sex is a normal part of pregnancy. In the case of a normal pregnancy, intercourse does not harm the baby.

How much blood is too much after sex while pregnant?

If you experience heavy bleeding after penetration, your pregnancy may be at risk, and you should follow up with your doctor or visit the ER.

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