Spotting is common during pregnancy and often has nothing to do with sex. However, heavy bleeding is a concern and should be reported to your practitioner.
Depending on the cause, bleeding can be mild or severe. It’s important to know what the signs are so you can seek the right care if needed.
Implantation bleeding
When an egg is fertilized by sperm, it attaches to the lining of the uterus and causes implantation bleeding. This happens a week or two before your expected menstruation cycle and can be one of the earliest signs of pregnancy. Implantation bleeding is light, stops on its own and doesn’t require treatment.
It may resemble spotting or a light period, and usually occurs pink or brown in color, compared to the red coloring of a typical menstrual flow. In addition, implantation bleeding usually lasts for just a few days whereas a period can last up to seven days.
While implantation bleeding is typically a good sign of pregnancy, it can be difficult to know for sure. That’s why a positive pregnancy test is the best way to confirm this early symptom. If your implantation bleeding is heavy or lasts longer than it should, talk to your doctor. Heavy bleeding can be a sign of an infection or a serious problem, such as a molar pregnancy or ectopic pregnancy. These conditions can cause life-threatening complications.
Placenta previa
When placenta previa occurs, the edge of the placenta covers or is positioned 2 cm from the internal cervical opening (cervix). Placenta previa can increase your risk for severe bleeding during labor and delivery, which can put you and your baby in danger.
This condition happens most often in the second trimester. Symptoms include bright red, painless vaginal bleeding that can range from light to heavy. It may also be accompanied by contractions, which can cause you to feel pressure or tightness in your abdomen or belly.
Your doctor can diagnose this condition through an ultrasound, either using a device on your stomach or by inserting a wand-like probe in your vagina. Your provider will avoid digital examination of the uterus and cervix, which can damage the placenta and lead to bleeding.
If you have placenta previa, your healthcare provider will recommend that you reduce physical activity and stop sexual intercourse. She will also ask you to not use tampons, as they can cause direct trauma to the previa and trigger bleeding. You may also need to have more frequent prenatal visits and ultrasound exams to see if the location of the placenta changes.
Cervical ectropion
Cervical ectropion happens when the lining of the uterus moves down past the top of the vaginal opening. This causes the cervix to become red and rough. It also produces heavy, mucus-like discharge that may be tinged with blood. This condition is common in teenagers and pregnant women. It can be a result of hormonal changes, and it usually doesn’t cause any serious health concerns or interfere with pregnancy in the slightest.
A doctor can diagnose cervical ectropion by performing a pelvic examination. They will look at the cervix and may use a pap smear to test for cervical cancer or sexually transmitted infections. They may also perform a colposcopy to examine the cervix closely with bright lighting and a magnifying device. They may even take a sample of tissue for a biopsy to check for precancerous or cancerous cells.
It is important to see a gynecologist if you are experiencing cervical ectropion or have a lot of bleeding with intercourse. This condition can be treated by a simple procedure called cryocautery or diathermy, which involves “freezing” the ectropion and allowing normal, thicker skin to grow in its place. It is a painless and quick procedure that can be performed in the doctor’s office under local anesthesia.
Infection
Infection happens when a germ or bacteria enters the body and starts to grow. Bacterial infections can range from mild to severe and can cause localized diseases like impetigo or boils or they can pass through the bloodstream into organs and causes systemic disease such as tetanus, whooping cough, diphtheria, pneumonia, gonorrhea, chlamydia and strep throat or even sepsis which is life-threatening.
Infectious diseases spread through droplets from someone who is coughing or sneezing, direct contact like kissing and oral or anal sex and from touching contaminated food, water or surfaces. They can also be spread from animals and ticks through a bite.
Some infections are contagious (like pertussis, typhoid and tuberculosis) but others are not such as a strep throat infection, bacterial vaginosis or a UTI. Bacterial vaginosis can be prevented by emptying your bladder often, wearing a pad or condom during sex and washing your hands frequently. UTIs are also preventable by not drinking too much fluid and taking antibiotic ointment or a prescription medicine like metronidazole. There are also vaccines for bacterial diseases.
Cervical cancer
Cervical cancer happens when healthy cells in the cervix (a pear-shaped organ that looks a bit like a donut and connects the uterus to the opening of the vagina) become abnormal and grow out of control. They form tumors and may spread to other parts of the body. It is the most common cancer among women in the United States, but it’s also very treatable and often curable if caught early.
Most cervical cancer starts in the thin, flat cells that line the outer part of the cervix. These are called squamous cells. Adenosquamous carcinoma is less common and begins in the column-shaped glandular cells that line the passage that runs to the uterus. Very rarely, cervical cancer can begin in other types of cells in the cervix.
Regular Pap tests and pelvic ultrasounds help identify pre-cancerous cells. These are usually followed by a biopsy. A healthcare professional uses a wire loop with an electric current to remove a cone-shaped sample of tissue from the cervix for examination under a microscope by a pathologist. A cone biopsy is often used if there are a lot of precancerous glandular changes in the cervix or when cancer is suspected.
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