Bleeding in early pregnancy is common, and it’s not always a sign of trouble. Most of the time, it’s light spotting caused by the embryo implanting in the womb wall.
This spotting is harmless and usually happens around the time you’d expect your period. But heavy bleeding can signal a serious complication such as placental abruption.
Causes
In early pregnancy, light bleeding after sex is not uncommon. It’s called implantation bleeding and occurs when the fertilized egg attaches to the lining of the uterus. The bleeding can be light or heavy and may also include semen. This is normal and not a cause for concern if the pregnancy is healthy.
A doctor can confirm whether or not this is the case by doing a pelvic exam or ultrasound. Your cervix is extra sensitive during the first trimester due to increased hormones, and this can trigger some bleeding. It can also bleed after a transvaginal ultrasound or when a doctor inserts a needle into the vagina for a blood test.
Other causes of bleeding in pregnancy include a miscarriage or other serious problems, such as ectopic pregnancy (when the fertilized egg grows outside the uterus) or placenta previa (where the placenta covers part or all of the cervix). Bleeding is usually accompanied by pain and should be reported to a doctor immediately.
Make sure to wear pads instead of tampons and be careful when exercising or having penetrative sex until your doctor tells you that it’s safe. Contact your doctor or midwife if the bleeding is very heavy, or if you have pain, cramps, fluid discharge, a fever, high-pitched sound during sex, or contractions. If you’re Rhesus negative, you might need to get an injection of anti-D immunoglobulin for the pregnancy to be successful.
Symptoms
Most of the time, a small amount of bleeding or spotting after sex in pregnancy is not a cause for alarm. But it is important to report this to your doctor and discuss it with her, especially if it is heavy or prolonged. Your doctor will also want to know any other symptoms you are experiencing, like abdominal pain or tender breasts. She may recommend using pads instead of tampons to monitor your bleeding and encourage you to rest as much as possible.
During the first trimester, about 15% to 25% of women experience bleeding. This often happens around the time of conception and is referred to as implantation bleeding. It usually lasts a few hours to a few days after the fertilized egg attaches itself to the uterine lining.
Heavier bleeding that is more than light spotting isn’t normal and could be a sign of complications such as ectopic pregnancy or placenta previa, which both require immediate medical attention.
Sex-triggered miscarriage is rare because the fetus is secure in the amniotic sac filled with fluid, which acts as a cushion to absorb any physical harm it might sustain (8). Infections like chlamydia or gonorrhea can also cause bleeding and should be treated by your healthcare provider.
Treatment
Most of the time, spotting and light bleeding after sex is normal. However, you should let your doctor know so they can check out the cause and see how far along you are in pregnancy. It is also helpful to note how heavy the bleeding is and if it is mixed with semen or other mucus, because it can help your doctor determine the cause.
Spotting or light bleeding after sex is usually because of progesterone, a hormone that encourages the growth of blood vessels on the cervix. This makes it easy for the cervix to be bruised or damaged during sex. It can also be caused by pelvic exams or ultrasounds that bump the cervix.
A spotting problem can also be a sign of sexually transmitted infections, such as chlamydia or gonorrhea, or of a urinary tract infection (UTI). These are serious conditions that should be treated right away.
Bleeding after sex at 12 weeks pregnant could also be a sign of an ectopic pregnancy. This is when the fertilized egg implants outside of the uterus, in the fallopian tubes or somewhere else. It is dangerous because the baby can’t develop normally outside of the womb. If you are experiencing any of the symptoms of an ectopic pregnancy, such as abdominal pain, fever or vomiting, call 111. They will arrange an emergency appointment for you with a doctor or midwife.
Prevention
Most women who are 12 weeks pregnant and have sex will not experience bleeding, but if you do, check in with your doctor, says Cross. Even if it’s only light spotting, she may want to examine your cervix and perform a pap smear.
Spotting during pregnancy often occurs because of implantation bleeding, which happens when a fertilized egg attaches to the uterus’ lining and causes a bit of blood. This spotting is usually light, pinkish or reddish and won’t last long, she adds.
The cervix also becomes more sensitive during pregnancy, making it more likely to bruise or bleed if it is bumped by sex or a physical exam. This is why you’ll sometimes see a little blood on toilet paper when wiping or in your panties or underwear, says Gaither.
She also warns of a condition called placenta previa, which can happen in the second trimester when the placenta covers the cervix completely or partially. This can cause life-threatening hemorrhaging, and she says sex isn’t the main cause of it.
If you have severe or frequent bleeding, your doctor may need to perform a procedure called dilation and curettage, which involves opening (dilating) the cervix and suctioning out the tissue, she notes. Usually, the doctor can tell from a look at the discharge whether it’s bleeding with clots or just a lot of fluid.
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