Noticing blood after sex can be alarming, and many women wait before mentioning it. In most cases the cause is something benign, but because one of the possible causes involves the cervix, bleeding that happens more than once is worth having examined rather than watched.
Common causes include vaginal dryness, which is frequent around perimenopause and while breastfeeding, a cervical ectropion, which is a harmless area of softer cervical surface that bleeds easily on contact, and cervical or vaginal infections. Polyps on the cervix can also bleed on contact. Less often, bleeding is a sign of changes in the cervical cells, which is why it is linked with checking that your screening is up to date and whether HPV has been tested.
The visit usually involves a short conversation about when the bleeding happens, how often, and your screening history, followed by a speculum examination so the cervix can be seen. Depending on what is found, the doctor may take swabs, do or update a cervical screening test, or look more closely with a colposcope. Treatment depends entirely on the cause, and many causes need little more than reassurance or a simple measure for dryness.
See a doctor if bleeding after sex happens more than once, if you are past menopause, if you have bleeding between periods, pelvic pain or unusual discharge, or if your last cervical screening was more than the recommended interval ago. Consultations are in English or Thai, with a fee of 1,500 to 3,000 baht by complexity plus a 300 baht clinic service fee.