Why do I have heavy bleeding after sex?

Question

Hello doctor,

I am 26 years old. I have seen my period in the second month of last year and miss it up for a further two months. I have seen it again after three months and stopped at the end of that month. But anytime I have sexual intercourse, I will bleed and past lots of blood clots for at least three days and then stop, and I waited for four days. I was good until I had sex again the same bleeding occurs, and there was lots of blood clot. Please help.

Answer 1

Hello,

Welcome to icliniq.com.

As there is oligomenorrhea and your menses have returned after a long time, eight months now, it is essential that the cause needs to be investigated. The likely reasons are PCOS (polycystic ovarian syndrome), hypothyroidism), or hyperprolactinemia. You need to get a complete hormonal profile with serum estradiol and serum testosterone levels with ultrasound pelvis to look for ovarian cysts (PCOS). The bleeding post intercourse is likely due to cervical erosions, which can cause bleeding and hence, a per speculum exam with a Pap smear is necessary as well. The ultrasound can deduce the endometrial thickness and if thick then an endometrial biopsy may also be taken for histopathological examination and learning the phase of the endometrium. In the meantime, you should be placed on antifibrinolytics like Tranexamic acid for controlling heavy bleeding. Obesity itself is a part of insulin resistance in PCOS, which can cause ovulation and hence delayed menses often. Please review with reports for further discussion and advice.