Q. I am bleeding after sex and my vaginal discharge is smelly. What to do?

Answered by
Dr. Sonal Prasad
and medically reviewed by iCliniq medical review team.
Published on Oct 09, 2019

Hello doctor,

I am 40 years old with three children, and my periods stopped a few months ago. After some time, I got a short period for one time; then it stopped for another three months. I started feeling unwell and thought it was just due to stress. I had some discharge, which was not itchy but had an odor. At first it was clear, then the discharge was creamy with a pink tinge for over a few days. The discharge became light bleeding after intercourse. I then began spotting, which lasted for approximately three weeks. I had intercourse with my teenaged partner and had pain followed by a medium to heavy bleeding, which lasted for over a week. It began to lighten, but I am feeling very unwell, nauseous at times, lethargic, etc. I had sex again, and during intercourse, the bleeding was heavy, accompanied by pain. Since then, I have heavy bleeding with clots. The odor is still there; the pain seems to have subsided, but I am bleeding, and passing clots and my vagina feels painful. Can you give me some advice on what this might be.

Dr. Sonal Prasad

Childbirth Educator Lactation Counselor Obstetrics And Gynaecology
#

Hello,

Welcome to icliniq.com.

Post-coital bleeding, along with vaginal discharge and menstrual abnormalities, must be further investigated. It can be due to uterine causes like a polyp or more likely due to cervical causes like polyp, erosion, LSIL (low-grade squamous intraepithelial lesion), etc. You need to get a serum TSH (thyroid-stimulating hormone), PRL (prolactin) value done along with USG gynae (ultrasound). You also need to get a per speculum examination done along with PAP smear and colposcopy. Check your hemoglobin level to assess the blood loss and need to be compensated if any.

I suggest to take table Tranexamic Acid 500 mg one tablet, three times a day for the bleeding. Please note that the medication is just for the symptomatic relief, and you must get the investigations mentioned above done even if the symptoms disappear for the time being.


Investigations to be done:

Hb,
TSH,
PRL,
USG Gynae,
pap smear and colposcopy.

Differential diagnosis:

Cervical erosion,
cervical polyp,
LSIL/HSIL, and
uterine polyp.

Treatment plan:

According to reports.

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