Aunt Vadge: copious bleeding after sex

Hi Aunt Vadge, 

For the past six years I have had bleeding after sex. I am not talking about a little drop or a streak, but it is like a small animal was slain in my sheets…

The only way it has been controlled is with birth control and sometimes that has not even worked. When I turned 31 in 2015 it got worse, and the birth control did not seem to help anymore. 

I had a d & c hysteroscopy in September 2015 and then had an IUD inserted a month later.  Everything was going fine during intercourse and I had no bleeding.

A month after the IUD was inserted my uterus contracted the IUD out.  After it came out I stayed off birth control and my vagina decided to start bleeding again after sex.

The first time was not too bad and I thought I was getting my period anyways because it was close to that time of the month. So I used my diva cup and went on my merry way…

Until my period got so bad by the 7 day I was filling up the cup every hour.  I suspect it was started by my boyfriend and got worse with the friction of taking the cup in and out. 

My ob/gyn said there cut on my cervix and had to use monsel’s [a paste used to stop bleeding] to stop the bleeding.

So a week and a half later we have sex for like 30 seconds and I bled a little bit, but the bleeding would not stop but did not get really bad, so I went back to the gyno, and she said I was bleeding from a little cut and from the os of my cervix.

Generally the bleeding is short and stops with in a few hours. But my body does not want me to use tampons or put anything up there because it feels irritated. I have had ultrasounds and pap smear, pap smears and STD test every month for the past 7-8 months.  Everything comes back normal.

I am begging for help. I would like to have another child in the next couple of years, but need this to get this resolved first and my gynecologist does not seem to know what is wrong with me. 

Thanks,
Unstoppable
Age 31, USA

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Hello Unstoppable,

I’m sorry to hear about the distressing situation you’re experiencing. Bleeding after intercourse (post-coital bleeding) for such an extended period is understandably concerning, and I’m sure it has been quite a journey going through various treatments and procedures.

Given that birth control methods have provided some relief in the past but are no longer as effective, and considering the repeated episodes of bleeding from your cervix and os, it suggests that there is an underlying issue that needs to be thoroughly investigated.

Since you’ve already had multiple tests and a hysteroscopy, and if the bleeding persists despite all normal test results, there may be a need for further, perhaps more specialised, investigation.

It could be beneficial to get a second opinion, perhaps from a different gynaecologist or a specialist in reproductive health. They may offer additional insights or suggest other diagnostic tests that have not been considered yet.

Here are some options to explore:

  1. Cervical ectropion (cervical erosion)
  2. Mid-cycle spotting and bleeding
  3. Dysfunctional uterine bleeding (DUB)

In the meantime, it’s crucial to minimise trauma to the cervix. This means avoiding tampons and sexual intercourse, or at least being extremely gentle, to prevent exacerbation of the cuts and bleeding you’ve described. When you do resume sexual activity, ensure ample lubrication to reduce friction and potential for injury.

Regarding your desire to have another child, it’s essential to resolve this issue to ensure a healthy environment for conception and pregnancy. Keep a detailed record of your symptoms, any treatments you’ve tried, and their effects, which can be extremely helpful for any healthcare professional you consult.

You may also want to explore some holistic approaches to support your reproductive system health. While these should not replace medical advice or treatment, lifestyle changes and certain supplements might promote healing and balance.

For instance, ensuring you have a nutrient-rich diet, full of antioxidants and anti-inflammatory foods, may help in tissue repair and overall wellness. However, always consult with your healthcare provider before starting any new supplement, especially considering your future pregnancy plans.

Since you’ve experienced quite some stress with this condition, addressing your emotional well-being is also important. Consider seeking support not only medically, but perhaps also someone to talk through the emotional impact of this ongoing issue.

Unstoppable, I truly hope you find a solution that allows you to heal and move forward with your plans for another child. Remember, advocating for your health is vital, and seeking multiple opinions is often a necessary step in addressing complex health issues.

Take care,
Aunt Vadge

References​1–4​

  1. 1.
    Zhang CY, Li H, Zhang S, et al. Abnormal uterine bleeding patterns determined through menstrual tracking among participants in the Apple Women’s Health Study. American Journal of Obstetrics and Gynecology. Published online February 2023:213.e1-213.e22. doi:10.1016/j.ajog.2022.10.029
  2. 2.
    Wright K, Mohammed A, Salisu-Olatunji O, Kuyinu Y. Cervical Ectropion and Intra-Uterine Contraceptive Device (IUCD): a five-year retrospective study of family planning clients of a tertiary health institution in Lagos Nigeria. BMC Research Notes. Published online 2014:946. doi:10.1186/1756-0500-7-946
  3. 3.
    Petre I, Sirbu D, Petrita R, Toma AD, Peta E, Dimcevici‑poesina F. Real‑world study of Cerviron® vaginal ovules in the treatment of cervical lesions of various etiologies. Biomed Rep. Published online July 7, 2023. doi:10.3892/br.2023.1618
  4. 4.
    Aggarwal P, Ben A. statpearls. Published online May 31, 2023. http://www.ncbi.nlm.nih.gov/books/NBK560709/


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