From the Guidelines
Postcoital bleeding in women can be a sign of an underlying gynecological problem, such as infections, polyps, fibroids, cervical changes, or more serious conditions, and warrants medical attention if persistent or heavy, especially if accompanied by pain, unusual discharge, or occurring after menopause. This condition may be caused by minor trauma to the cervix during intercourse, hormonal fluctuations, or other factors. According to the most recent and highest quality study, if clinically indicated, consider an underlying gynecological problem, such as interactions with other medications, an STD, pregnancy, or new pathologic uterine conditions (e.g., polyps or fibroids) 1. The study also suggests that medical treatments for abnormal uterine bleeding associated with ovulatory dysfunction include progestin-only contraception and combined hormonal contraception. If medical treatment fails, is contraindicated, or is not tolerated, or if the patient has concomitant significant intracavitary lesions, surgery, including endometrial ablation and hysterectomy, may be an option 1. Some possible causes of postcoital bleeding include:
- Minor trauma to the cervix during intercourse
- Hormonal fluctuations, particularly in those using hormonal contraceptives
- Infections, such as sexually transmitted diseases
- Polyps or fibroids
- Cervical changes or other gynecological conditions It is essential to consult with a healthcare provider for proper evaluation and diagnosis if you experience recurrent episodes of postcoital bleeding, increasing pain, heavy bleeding, or have concerns. The healthcare provider may recommend treatment options, such as NSAIDs for short-term treatment or hormonal treatment, depending on the underlying cause of the bleeding 1.
From the Research
Definition and Causes of Postcoital Bleeding
- Postcoital bleeding in women refers to bleeding that occurs after sexual intercourse.
- The provided studies do not directly address postcoital bleeding, but they discuss various gynecological issues and bleeding disorders in women.
- According to 2, women and girls with bleeding disorders experience abnormal and excessive bleeding, which can negatively impact their overall health and quality of life.
Gynecological Examinations and Bleeding Disorders
- Routine pelvic examinations are not recommended for asymptomatic women as a screening test for ovarian cancer or other pathology 3.
- Colposcopy is used to evaluate women with genital tract abnormalities and abnormal cervical cytology 4, 5.
- The Swede scoring system is used in colposcopic examinations to diagnose premalignant/malignant lesions in reproductive age group women using various contraceptives 5.
Management and Treatment of Bleeding Disorders
- Heavy menstrual bleeding (HMB) is defined as excessive menstrual blood loss that interferes with a woman's physical, emotional, social wellbeing, and quality of life 6.
- Management of HMB depends on the underlying cause and the woman's preference and fertility wishes, and may include medical therapies such as hormonal treatments, haemostatic therapies, and surgical procedures like endometrial ablation or hysterectomy 6.
- Women with bleeding disorders may require specialized care and treatment, including factor concentrate administration during menses to alleviate symptoms 2.