Occasional vaginal or anal spotting usually isn’t cause for concern. Penile bleeding, however, usually occurs from an underlying injury or infection.

Light bleeding during sexual activity often occurs from a lack of lubrication, especially during vigorous vaginal or anal penetration. In some cases, bleeding could relate to an underlying condition.

Make an appointment with a healthcare professional if you have:

  • frequent bleeding or bleeding without sexual activity
  • severe pelvic pain or cramping
  • pain or burning during urination
  • new or unusual discharge or lesions
  • fever

They can perform a pelvic exam, order lab tests to screen for sexually transmitted infections (STIs), and advise you on any next steps.

One of the most common reasons for genital bleeding during sex is cervix or vaginal canal irritation.

In people of reproductive age, the source of bleeding is usually their cervix. Conditions like cervicitis (cervix inflammation) can increase the risk of bleeding during penetrative sex.

People in menopause or postmenopause, however, are more likely to experience bleeding within their vaginal canal. Dryness or insufficient lubrication can lead to small tears in their vaginal walls, which might bleed.

Hormonal changes

Hormonal changes from contraceptives, pregnancy, or perimenopause can result in spotting after sex.

People taking hormonal birth control, especially the pill, may experience breakthrough bleeding during or after sex. This type of bleeding is common in the first few months of starting hormonal contraception or when switching methods.

If you experience consistent bleeding, it might mean the method isn’t working, or a dosage adjustment is necessary.

Infections

Some STIs — such as chlamydia, gonorrhea, and trichomoniasis — cause inflammation. This inflammation can make the tissues in your genital area more prone to injury, resulting in bleeding during sex.

Bacterial vaginosis and yeast infections can also lead to irritation and slight bleeding.

Consult a healthcare professional if you experience other symptoms, such as unusual discharge, pain, or a strong odor.

Growths

Noncancerous growths in your uterus or cervix, like fibroids or polyps, can cause bleeding during or after penetrative sex. These are usually noncancerous but may require treatment if they cause persistent symptoms.

Endometriosis, a condition where tissue similar to your uterine lining grows outside your uterus, can also cause pain and bleeding during penetration.

Sometimes, rough or vigorous sex can cause urethral injury, particularly if penetration is deep or there’s not enough lubrication. This injury can lead to bleeding from your urethra during or after sex.

If you notice blood in your urine, this could indicate urethral injury, which requires medical attention.

STIs

Chlamydia, gonorrhea, and syphilis can lead to urethritis (urethra inflammation) and cause penile bleeding during sex.

These conditions often present with additional symptoms like sores, discharge, or pain during urination.

Prostate conditions

Conditions affecting your prostate, such as prostatitis (prostate inflammation) or benign prostatic hyperplasia, can contribute to bleeding during sex.

These conditions might cause discomfort, pain, or bleeding due to your prostate’s proximity to your ejaculatory ducts.

Penile fracture

A penile fracture is a rare but serious cause of bleeding during sex. This fracture occurs when there’s an injury to your erect penis, usually from forceful or aggressive sexual activity.

A penile fracture ruptures tissue known as your corpus cavernosa, leading to significant pain, swelling, bruising, and bleeding. This injury requires immediate medical attention, and surgery may be necessary to repair the injury.

Swollen veins in your rectum, or hemorrhoids, are a leading cause of anal bleeding. Receptive anal sex can worsen hemorrhoids, causing them to bleed.

Over-the-counter creams can soothe hemorrhoids and prevent further bleeding.

Fissures

Anal fissures, or small tears in the skin around your anus, can cause sharp pain and noticeable bleeding during or after anal sex. Fissures may also cause a burning sensation or itching.

Without treatment, anal fissures can become infected.

STIs

STIs like chlamydia, gonorrhea, and syphilis can cause irritation or ulcers in your anal area, leading to bleeding during sexual activity. You may also experience pain or unusual discharge.

Proctitis

Proctitis (rectum lining inflammation) can occur from infections, inflammatory bowel disease (IBD), or radiation therapy. Proctitis can cause bleeding, pain, or a feeling of urgency to have a bowel movement.

Genital or anal bleeding during sexual activity can have a range of causes, from minor irritation to more serious underlying conditions. Light bleeding is often nothing to worry about.

But if the bleeding is persistent, painful, or accompanied by other concerning symptoms, it’s important to consult a healthcare professional. Early diagnosis and treatment can help reduce the risk of long-term complications.