Post-coital bleeding
What is post-coital bleeding? Post-coital bleeding is bleeding after intercourse. What causes post-coital bleeding? There are many causes for bleeding after intercourse, such as: An infection Damage to the vagina such as tears after childbirth Damage to the vagina from dryness or friction during intercourse Cervical polyps Endometrial polyps Cervical ectropion, when cells f
What it is
Common causes include cervical ectropion (cells of the inner cervix exposed on the outer surface, often with the combined contraceptive pill), endocervical or endometrial polyps, vaginal atrophy in peri/post-menopausal women, infection (chlamydia, gonorrhoea, trichomonas) and (less commonly) cervical pre-cancer or cancer.
When this is relevant
- Bleeding noticed during or after sexual intercourse.
- Any persistence beyond a single episode warrants assessment.
- Coexisting pelvic pain, abnormal discharge or pain on intercourse.
- History of abnormal smear or persistent HPV infection.
- Post-menopausal women - prompt assessment essential (overlap with red-flag presentation).
How we investigate
Detailed history, pelvic examination, speculum exam, cervical screening if due, STI panel, transvaginal pelvic ultrasound. Colposcopy where any cervical lesion is seen or smear is abnormal.
Options at The Vesey
- Cervical ectropion management - reassurance, contraception review, silver nitrate cautery if symptomatic.
- STI eradication with partner notification.
- Polypectomy - outpatient hysteroscopic removal of any identified polyp.
- Vaginal oestrogen - for atrophy-related bleeding in peri/post-menopausal women.
- Colposcopy and biopsy - immediate pathway for any suspicious cervical appearance.
Is post-coital bleeding always a sign of something serious? +
Not always — the commonest cause is a benign cervical ectropion or a polyp, both easily treated. However, post-coital bleeding is also an early symptom of cervical cancer, so every case deserves proper assessment. A single episode is enough to warrant being seen.
Do I need a cervical smear if I have post-coital bleeding? +
Yes, if your smear is overdue or if the last result was abnormal. Post-coital bleeding with an abnormal smear or persistent HPV infection triggers direct colposcopy referral. Even with a recent normal smear, a consultant examination is still essential to exclude other causes.
Can a cervical ectropion cause post-coital bleeding? +
Yes. A cervical ectropion (where the inner glandular cells of the cervix are exposed on the outer surface) is very friable and bleeds easily on contact. It is common with the combined contraceptive pill and in pregnancy. Treatment options include reassurance, contraception change, or silver nitrate cautery.
What happens at a post-coital bleeding consultation? +
Your consultant will take a detailed history, perform a pelvic and speculum examination, check your cervical screening status, arrange an STI panel and transvaginal ultrasound, and proceed to colposcopy at the same visit if there is any abnormal cervical appearance. Most investigations are same-day.
Pricing at a glance
Initial consultation £260. STI panel from £190. Pelvic ultrasound from £240. Colposcopy from £650. Insurance accepted: BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix.
Book an appointment
When to book
Book this week. Post-coital bleeding is a symptom that deserves clarity, not "wait and see".
Cost and pathway
Initial consultation £260. STI panel from £190. Pelvic ultrasound from £240. Colposcopy from £650.
- Open 7 days including Sundays — 8am to 8pm, no weekend surcharge
- No GP referral required — book directly with our gynaecology team
- Sutton Coldfield location — serving Birmingham, Walsall, Tamworth, Lichfield and the West Midlands
- CQC-regulated — rated 4.88/5 on Doctify from 700+ verified reviews
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Sutton Coldfield · Birmingham · Walsall · Tamworth · Lichfield · West Midlands · Open 7 days 8am–8pm
Open 7 days · 8am–8pm · 0121 387 3727