Page last updated November 2021

I’m pregnant and bleeding after sex, should I worry?

I'm pregnant and bleeding after sex, should I worry?

Bleeding during pregnancy is common, affecting 25% of those in the first trimester.1 This can understandably cause worry but is not always a sign of something sinister.

The body goes through a lot of changes during pregnancy and some of those can cause bleeding after sex and at other times. Unless your doctor has told you not to, it is perfectly safe to have sex while pregnant — a penis, fingers, or a sex toy won’t be able to penetrate beyond your vagina and will not affect the baby at all.2

It’s important to recognise when your bleeding may be a sign of something more, so that you can get checked out by your doctor right away. In this article, we will discuss some of the common causes of bleeding after sex during pregnancy, as well as giving you some guidance on when to seek further medical attention.

Common reasons for bleeding after sex during pregnancy

Changes to the cervix

During pregnancy, changes in the levels of hormones, in particular an increase in the hormone oestrogen, cause changes to the cervix including increasing its blood supply.3 This can cause something called cervical ectropion to develop — this is a glandular change, where cells which are normally seen inside of the cervix, grow on the outside.

Ectropion is common, particularly during puberty, in those who take the combined contraceptive pill, and those who are pregnant. This is because all three of these groups have higher levels of oestrogen.

It is important to know that ectropion is a completely safe change to your cervix and is nothing to worry about

Cervical ectropion can lead to bleeding during or after sex, as the penis, fingers, or penetrative toy can irritate the cells, which are soft, causing them to bleed.4 The bleeding will usually be light (spotting)5 and whilst you may see it in your underwear, you might only notice it when you wipe after going to the toilet.

The blood is often pink or light brown or may appear as blood-streaked discharge during or just after sex. The bleeding will stop by itself, and there should not be any clots, or other symptoms such as abdominal pain.

It is important to know that ectropion is a completely safe change to your cervix and is nothing to worry about. Cervical ectropion is benign and does not lead to cervical cancer.6 Often the changes will go away once hormone levels return to normal after pregnancy.

Implantation bleeding

This is bleeding that happens around 10-14 days after fertilisation of the egg. It is caused by the embryo implanting into the wall of your womb and will usually be around the time of your normal period,7 however, it will be much lighter and only lasts for about a day.

This bleeding is not necessarily associated with sex, however if you have sex around this time, it may seem like it is. You may start to notice other symptoms of pregnancy such as tender breasts and fatigue.

You can still catch sexually transmitted infections whilst pregnant, and so it’s important to practice safe sex

Infection

Infection can be a cause of bleeding after sex, particularly infections such as chlamydia and gonorrhoea.8 Depending on the infection, your bleeding may be associated with other symptoms, such as changes to your vaginal discharge. If you are worried you may have an infection, it is best to visit your GP or local sexual health clinic for swabs to test for an infection.

You can still catch sexually transmitted infections whilst pregnant, so it’s important to practice safe sex, taking precautions such as barrier protection use and being screened regularly for STIs.

When should I be worried about my bleeding?

In many cases, bleeding after sex in pregnancy is not a sign of anything more concerning. However, sometimes the bleeding may be a sign of something else, particularly if the bleeding is heavy or is accompanied by other symptoms such as abdominal pain. This sort of bleeding may occur after sex but also at other times.

Miscarriage

Bleeding or pain during the first 12 weeks of pregnancy can be a sign of miscarriage. While miscarriages are reasonably common, it is important to remember that not all bleeding in pregnancy will be a sign of a miscarriage. Other symptoms of a miscarriage are cramping and pain in your lower tummy, vaginal discharge, and suddenly not experiencing pregnancy symptoms you were before.

Many who experience a threatened miscarriage go on to have a healthy baby

However, vaginal bleeding is the most common sign of miscarriage9 and if you’re experiencing this, it’s best to get checked out by a doctor to rule out anything sinister. Bleeding can be anything from light to heavy and bright red with clots and can come and go over the course of a few days.

In some cases, bleeding may be a sign of an early miscarriage10 (a miscarriage occurring in the first 12 weeks of pregnancy), however for some, it may be a sign of a threatened miscarriage. This is where there is bleeding and/or pain but your pregnancy continues to progress as normal. Many who experience a threatened miscarriage go on to have a healthy baby.11

Ectopic pregnancy

In some cases, bleeding during pregnancy can be a sign of an ectopic pregnancy. This is a pregnancy in which the baby is growing outside of the womb. Around 1 in 90 pregnancies in the UK will be ectopic, and bleeding may be accompanied by other symptoms such as shoulder pain, dizziness, fainting, severe abdominal pain, diarrhoea or vomiting. If you are concerned you may have an ectopic pregnancy, you should contact your early pregnancy assessment unit or A&E urgently.12

Bleeding after 12 weeks of pregnancy

Bleeding after 12 weeks of pregnancy is much less common. There are many causes of bleeding after 12 weeks, including those which are less concerning, however it is best to seek medical advice especially if the bleeding is late in your pregnancy.13

Whilst bleeding during pregnancy can feel worrying, it is important to remember many who experience bleeding in the first trimester go on to have a normal pregnancy with a healthy baby and that unless you have been advised otherwise by a healthcare professional, it is completely safe to continue having sex during pregnancy.14

If you experience bleeding in early pregnancy, you can seek help and advice from your GP, midwife, local pregnancy unit, or if the bleeding is very heavy or pain is severe, A&E.15
 
 
Featured image is an illustration of a pregnant person lying on their side in bed, with their left hand resting on their belly and a worried expression on their face
 
 
Page last updated November 2021
Next update due 2024

Bleeding during pregnancy is common, affecting 25% of those in the first trimester.1 This can understandably cause worry but is not always a sign of something sinister.

The body goes through a lot of changes during pregnancy and some of those can cause bleeding after sex and at other times. Unless your doctor has told you not to, it is perfectly safe to have sex while pregnant — a penis, fingers, or a sex toy won’t be able to penetrate beyond your vagina and will not affect the baby at all.2

It’s important to recognise when your bleeding may be a sign of something more, so that you can get checked out by your doctor right away. In this article, we will discuss some of the common causes of bleeding after sex during pregnancy, as well as giving you some guidance on when to seek further medical attention.

Common reasons for bleeding after sex during pregnancy

Changes to the cervix

During pregnancy, changes in the levels of hormones, in particular an increase in the hormone oestrogen, cause changes to the cervix including increasing its blood supply.3 This can cause something called cervical ectropion to develop — this is a glandular change, where cells which are normally seen inside of the cervix, grow on the outside.

Ectropion is common, particularly during puberty, in those who take the combined contraceptive pill, and those who are pregnant. This is because all three of these groups have higher levels of oestrogen.

It is important to know that ectropion is a completely safe change to your cervix and is nothing to worry about

Cervical ectropion can lead to bleeding during or after sex, as the penis, fingers, or penetrative toy can irritate the cells, which are soft, causing them to bleed.4 The bleeding will usually be light (spotting)5 and whilst you may see it in your underwear, you might only notice it when you wipe after going to the toilet.

The blood is often pink or light brown or may appear as blood-streaked discharge during or just after sex. The bleeding will stop by itself, and there should not be any clots, or other symptoms such as abdominal pain.

It is important to know that ectropion is a completely safe change to your cervix and is nothing to worry about. Cervical ectropion is benign and does not lead to cervical cancer.6 Often the changes will go away once hormone levels return to normal after pregnancy.

Implantation bleeding

This is bleeding that happens around 10-14 days after fertilisation of the egg. It is caused by the embryo implanting into the wall of your womb and will usually be around the time of your normal period,7 however, it will be much lighter and only lasts for about a day.

This bleeding is not necessarily associated with sex, however if you have sex around this time, it may seem like it is. You may start to notice other symptoms of pregnancy such as tender breasts and fatigue.

You can still catch sexually transmitted infections whilst pregnant, and so it’s important to practice safe sex

Infection

Infection can be a cause of bleeding after sex, particularly infections such as chlamydia and gonorrhoea.8 Depending on the infection, your bleeding may be associated with other symptoms, such as changes to your vaginal discharge. If you are worried you may have an infection, it is best to visit your GP or local sexual health clinic for swabs to test for an infection.

You can still catch sexually transmitted infections whilst pregnant, so it’s important to practice safe sex, taking precautions such as barrier protection use and being screened regularly for STIs.

When should I be worried about my bleeding?

In many cases, bleeding after sex in pregnancy is not a sign of anything more concerning. However, sometimes the bleeding may be a sign of something else, particularly if the bleeding is heavy or is accompanied by other symptoms such as abdominal pain. This sort of bleeding may occur after sex but also at other times.

Miscarriage

Bleeding or pain during the first 12 weeks of pregnancy can be a sign of miscarriage. While miscarriages are reasonably common, it is important to remember that not all bleeding in pregnancy will be a sign of a miscarriage. Other symptoms of a miscarriage are cramping and pain in your lower tummy, vaginal discharge, and suddenly not experiencing pregnancy symptoms you were before.

Many who experience a threatened miscarriage go on to have a healthy baby

However, vaginal bleeding is the most common sign of miscarriage9 and if you’re experiencing this, it’s best to get checked out by a doctor to rule out anything sinister. Bleeding can be anything from light to heavy and bright red with clots and can come and go over the course of a few days.

In some cases, bleeding may be a sign of an early miscarriage10 (a miscarriage occurring in the first 12 weeks of pregnancy), however for some, it may be a sign of a threatened miscarriage. This is where there is bleeding and/or pain but your pregnancy continues to progress as normal. Many who experience a threatened miscarriage go on to have a healthy baby.11

Ectopic pregnancy

In some cases, bleeding during pregnancy can be a sign of an ectopic pregnancy. This is a pregnancy in which the baby is growing outside of the womb. Around 1 in 90 pregnancies in the UK will be ectopic, and bleeding may be accompanied by other symptoms such as shoulder pain, dizziness, fainting, severe abdominal pain, diarrhoea or vomiting. If you are concerned you may have an ectopic pregnancy, you should contact your early pregnancy assessment unit or A&E urgently.12

Bleeding after 12 weeks of pregnancy

Bleeding after 12 weeks of pregnancy is much less common. There are many causes of bleeding after 12 weeks, including those which are less concerning, however it is best to seek medical advice especially if the bleeding is late in your pregnancy.13

Whilst bleeding during pregnancy can feel worrying, it is important to remember many who experience bleeding in the first trimester go on to have a normal pregnancy with a healthy baby and that unless you have been advised otherwise by a healthcare professional, it is completely safe to continue having sex during pregnancy.14

If you experience bleeding in early pregnancy, you can seek help and advice from your GP, midwife, local pregnancy unit, or if the bleeding is very heavy or pain is severe, A&E.15
 
 
Featured image is an illustration of a pregnant person lying on their side in bed, with their left hand resting on their belly and a worried expression on their face
 
 
Page last updated November 2021
Next update due 2024

Dr Lydia Gittings MBChB

Lydia is a Foundation Year 1 junior doctor who studied at the University of Leicester. During her time at university she developed an interest in sexual and women’s health via her work with the RSE charity Sexpression and an interest in writing. Lydia believes that accessibility to information is key to allowing individuals to make informed and autonomous decisions about their health and is keen to dispel misinformation surrounding these topics. When not working, you’re likely to find Lydia flying on aerial silks or eating.

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References

  1. BMJ, Assessement of vaginal bleeding, BMJ Best Practice, October 2021 [online] [accessed 15th November 2021]
  2. NHS, Sex in pregnancy, NHS website, March 2021 [online] [accessed 15th November 2021]
  3. ACOG, Bleeding during pregnancy — FAQs, The American College of Obstetricians and Gynecologists, May 2021 [online] [accessed 15th November 2021]
  4. Baldwin, A., ‘The cervix and cervical screening,’ in  Oxford Handbook of clinical specialities, Oxford University Press, eleventh edition, 2020, pp 164
  5. Tobah, Y.B., Is implantation bleeding normal in early pregnancy?, MayoClinic, May 2019 [online] [accessed 15th November 2021]
  6. Saint Mary’s Hospital Emergency Gynaecology Unit, Cervical Ectopy (cervical erosion), Information for patients, Manchester University – NHS Foundation Trust, June 2018, [online] [accessed 15th November 2021]
  7. NHS, Vaginal Bleeding, NHS website, March 2021, [online] [accessed 15th November 2021]
  8. Baldwin, A., ‘The cervix and cervical screening,’ in  Oxford Handbook of clinical specialities, Oxford University Press, eleventh edition, 2020, pp 164
  9. NHS, Miscarriage, NHS website, June 2018 [online] [accessed 15th November 2021]
  10. RCOG, Early Miscarriage- patient information, Royal College of Obstetricians and Gynaecologists, September 2016, [online] [accessed 15th November 2021]
  11. RCOG, Bleeding and/or pain in early pregnancy – patient information, Royal College of Obstetricians and Gynaecologists, September 2016, [online] [accessed 15th November 2021]
  12. Ibid
  13. ACOG, Bleeding during pregnancy — FAQs, The American College of Obstetricians and Gynecologists, May 2021 [online] [accessed 15th November 2021]
  14. NHS, Sex in pregnancy, NHS website, March 2021 [online] [accessed 15th November 2021]
  15. RCOG, Bleeding and/or pain in early pregnancy – patient information, Royal College of Obstetricians and Gynaecologists, September 2016, [online] [accessed 15th November 2021]

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