Differential Diagnosis for Bleeding with Sex

• Single most likely diagnosis
  • Cervicitis: This condition, which is an inflammation of the cervix, can cause bleeding after sexual intercourse. It's often due to a sexually transmitted infection (STI) and is a common cause of postcoital bleeding.
• Other Likely diagnoses
  • Vaginal Dryness: Insufficient lubrication during sex can lead to vaginal tears or irritation, resulting in bleeding. This is common in postmenopausal women or those with hormonal imbalances.
  • Endometrial Polyps: These are growths in the lining of the uterus and can cause irregular menstrual bleeding, including bleeding after sex.
  • Uterine Fibroids: Noncancerous growths of the uterus that can cause heavy or irregular menstrual bleeding and bleeding after intercourse.
• Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
  • Cervical Cancer: Although less common, cervical cancer can cause bleeding after sex. It's crucial to rule out this diagnosis with appropriate screening and testing.
  • Endometrial Cancer: Cancer of the uterus lining can also present with postcoital bleeding, among other symptoms.
  • Pelvic Inflammatory Disease (PID): An infection of the female reproductive organs that can cause bleeding, pain, and other severe complications if not treated promptly.
• Rare diagnoses
  • Vaginal Cancer: A rare type of cancer that can cause bleeding, including after sexual intercourse.
  • Trauma: Physical trauma to the genital area, which could be accidental or non-accidental, and results in bleeding.
  • Blood Clotting Disorders: Certain conditions that affect blood clotting can lead to easy bruising or bleeding, including after sex. However, these would typically present with a broader range of symptoms.