There are a number of reasons you might experience bleeding after sex. If you have an intrauterine device (IUD), you might wonder if bleeding after sex is a normal side effect.
An IUD is a small, T-shaped device. Your doctor can insert it into your uterus to prevent pregnancy. According to Planned Parenthood, less than 1 out of 100 women who use an IUD will get pregnant in a year. That makes it one of the most effective birth control options available.
IUDs protect against pregnancy but not sexually transmitted infections (STIs). To avoid contracting or spreading STIs, use condoms along with your IUD.
The two main types of IUD are copper IUDs and hormonal IUDs. ParaGard is a copper IUD, and Mirena and Skyla are hormonal IUDs.
Copper IUDs are plastic devices wrapped in copper. In most cases, you can use a copper IUD for 12 years before you need to replace it. You can even use it as emergency birth control by inserting it within five days after unprotected sex.
Hormonal IUDs contain the hormone progestin. Depending on the brand, they should be replaced every three to five years. They may help ease menstrual symptoms and may even stop your period completely.
IUDs are safe for most women. However, they can cause some side effects.
Side effects during menstruation
After you have your IUD inserted, you may experience heavy periods and breakthrough bleeding for three to six months. This bleeding is usually heaviest in the hours and days after insertion.
Copper IUDs also raise your risk of heavy bleeding, cramping, and backaches during menstruation beyond the first three to six months. Your periods will likely normalize after six months. You should talk to your doctor if they don’t.
Hormonal IUDs tend to make your periods lighter and less painful over time. According to the company that manufactures the Mirena IUD, about 20 percent of women stop having periods after using the device for a year.
Side effects during or after sex
Beyond the initial three to six months, you probably won’t experience breakthrough bleeding with your IUD. It shouldn’t cause bleeding after sex either. If you notice bleeding after sex, contact your doctor. They can help you identify the cause and discuss treatment options.
If you experience pain during sex, speak to your doctor. Your IUD may be out of place. Your doctor can check its placement and reposition it if needed. They can also rule out other possible causes of your pain. Some causes of pain during sex require treatment.
Additional side effects of hormonal IUDs
Hormonal IUDs may cause other side effects, including:
- acne or other skin issues
- breast tenderness
- pelvic pain
- weight gain
- mood changes
- ovarian cysts
If you suspect you’re experiencing side effects from you IUD, tell your doctor. They can help you identify the cause of your symptoms. They can also discuss your birth control options. Read more about IUDs and infections.
If you experience bleeding after sex, it may not be caused by your IUD.
If you haven’t gone through menopause yet, the source of your bleeding is probably through your cervix, which is the lower, narrow end of your uterus. Friction from sex can irritate it and cause some bleeding. If your cervix is inflamed, it can also lead to bleeding. In most cases, occasional bleeding after sex is no cause for concern for premenopausal women.
If you’ve already gone through menopause, the source of your bleeding may be:
- your cervix
- your uterus
- your labia
- the opening of your bladder
Vaginal dryness or more serious conditions may be the cause.
Other possible causes include:
- sex at the beginning or end of your menstrual cycle
- cervical cancer, which you can screen for with routine Pap smears
- cervical ectropion, which is a condition that can affect the inner lining of your cervix
- cervical polyps, which are noncancerous growths that can develop on your cervix
- vaginitis, which is inflammation of your vagina
- STIs, such as herpes or syphilis
- injuries to your uterine lining
If you’re premenopausal, take note of bleeding after sex. It’s usually not a sign of a serious health issue. The culprit is more likely irritation. However, bleeding that occurs frequently or heavily may be a sign of cervical cancer or another underlying health condition.
Postmenopausal women should pay careful attention to bleeding after sex. Any bleeding after sex is considered abnormal if you’ve already gone through menopause. You should tell your doctor about it. Vaginal dryness may be the cause, but it’s best to rule out more serious medical conditions.
Your doctor will likely perform a few tests to help find the cause of your bleeding. Depending on your age and medical history, they may perform the following:
- A pregnancy test to rule out pregnancy. Although IUDs are highly effective, it’s still important to rule out pregnancy if you’re of reproductive age and sexually active.
- A pelvic exam. During this exam, your doctor may also use a device called a speculum to spread your vaginal walls apart and visually examine your vagina and cervix. Your doctor will also insert their fingers into your vagina to check for abnormalities.
- A Pap smear to rule out cervical cancer.
Your doctor may also collect other samples from your vagina, cervix, or uterus to check for STIs or other conditions.
Routine Pap smears and pelvic exams can help you catch some conditions early. Make sure that you go to your routine medical appointments.
Depending on the cause of the bleeding, your doctor may prescribe a variety of treatments:
- If your irritation is from vaginal dryness, they may advise you to use lubricant during sex.
- If your irritation is caused by friction or trauma, they may encourage you to practice gentler sex.
- If you have an STI or other infections, they may prescribe medications.
- If you have cervical cancer or polyps, they may recommend surgery or other procedures.
- If your uterine lining has been injured, they may advise you to avoid sex for two weeks.
If you’re premenopausal, occasional bleeding after sex is relatively common. Speak to your doctor if bleeding is frequent, heavy, or accompanied by other symptoms. If you have pain, your doctor may need to check the placement of your IUD. Read more about other birth control methods here.
If you’re postmenopausal, tell your doctor about any bleeding after sex.