What causes hemoptysis (coughing up blood) during sexual intercourse?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: April 9, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

Differential Diagnosis for Hemoptysis during Sex

  • Single most likely diagnosis
    • Pulmonary embolism: This condition is a leading cause of sudden death and can be triggered by intense physical activity, including sex. The increased pressure and strain during sexual activity can dislodge a clot, leading to a pulmonary embolism, which may cause hemoptysis.
  • Other Likely diagnoses
    • Pneumonia or bronchitis: Respiratory infections can cause inflammation and irritation of the airways, leading to hemoptysis. The physical exertion of sex may exacerbate the condition, causing bleeding.
    • Chronic obstructive pulmonary disease (COPD): COPD patients may experience hemoptysis due to the chronic inflammation and damage to the lungs. Physical activity, including sex, can worsen symptoms.
    • Mitral stenosis: This heart condition can lead to increased pressure in the pulmonary veins, causing hemoptysis. The physical strain of sex may exacerbate the condition.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Pulmonary arteriovenous malformation (AVM): A rare condition where abnormal connections between arteries and veins in the lungs can cause hemoptysis. Although unlikely, missing this diagnosis could be fatal.
    • Goodpasture syndrome: A rare autoimmune disease that can cause hemoptysis and renal failure. It is essential to consider this diagnosis to provide timely and appropriate treatment.
    • Tuberculosis: Although less common in some regions, tuberculosis can cause hemoptysis and is a critical diagnosis to consider, especially in high-risk populations.
  • Rare diagnoses
    • Bronchiectasis: A condition characterized by damaged airways, which can cause hemoptysis. While not directly related to sex, the physical exertion may worsen symptoms.
    • Catamenial pneumothorax: A rare condition where menstrual-related changes cause air to leak into the space between the lungs and chest cavity, potentially leading to hemoptysis.
    • Behçet's disease: A rare autoimmune disorder that can cause hemoptysis, among other symptoms. Although unlikely, it is essential to consider this diagnosis in patients with a history of recurrent oral and genital ulcers.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.