Question: vaginal bleeding after intercourse

joyce asked:

I noticed blood coming out from my vagina and anus after vaginal intercourse.

what might be the cause?

There are several causes of bleeding after vaginal intercourse. But first let me state a couple of facts (I’m reusing a partial answer published before):

The cervix is the part of the uterus in direct contact with the vagina. Cervix morphology changes throughout a woman’s life, and these modifications are hormone related. In addition to those changes, several factors, such as sexual transmitted diseases, HPV infection, tobacco, and hormonal contraception, explain the development of cervical diseases (precancerous lesions for example) that may cause bleeding after vaginal intercourse. These are usually diagnosed with pap smears or biopsies. However, women may bleed after intercourse due to “cervical erosion” (also known as cervical ectropion) that occurs as a consequence of the hormonal status. So, bleeding after vaginal intercourse may occur as a consequence of cervical lesions but also when no serious cervical disease underlies.

Now, you tell me that you also bled from your anus after vaginal intercourse… are you sure? If that’s the case, a trauma as well as an anal lesion may be the cause.

You posed the question very vaguely, therefore I can’t be more specific. Here are some answers I would need in order to provide a more accurate response: How old are you? Did this happened for the first time without recurrence? Did you feel any pain? Did you recently notice a vaginal discharge? Did you notice any lesions? When was the last time you went to a gynecologist? When was the last time you took a pap smear? Do you take oral contraceptive pills?

The reality about senior sex

There’s a myth among younger generations that makes sort of a common sense assumption that seniors don’t have sex. Nothing further from the truth: they have interest in sex and they actually do have sex. However, if sexual problems arise, they’re quickly dismissed by the inevitability of ageing and, quite frequently, seniors don’t seek professional help.

A study published in the New England Journal of Medicine by Lindau and his colleges answered some questions in regard to prevalence of sexual activity, behaviors, and problems. From a sample of 3005 people, 73 percent of those aged 57-64 reported sexual activity, as did those between 65-74 (53%) and 75-85 (26%). Within the sexually active group, half reported at least one sexual problem. The highest ranking problem identified in females was diminished libido (43%) followed by lack of vaginal lubrication (39%) and inability to reach orgasm (34%). On the other hand, among men, erectile difficulties topped the list of problems (37%). The authors also conclude that only 38 percent of men and 22 percent of women discussed their sexual issues with a physician.

Talking to a physician is fundamental: the full understanding of underlying physical issues may allow for their resolution. For example, after menopause women have less vaginal lubrication and this can be treated with lubricants or topic hormonal preparations. Male impotence may be due to heart disease, high blood pressure, diabetes, or even as a side effect of the drugs used to treat these or other medical conditions. Its resolution can be achieved by treating the disease or changing the drug regimen. Impotence by itself can be treated with a pill called sildenafil, self-injection of drugs (papaverine or prostaglandin E2), vacuum devices, or penile implants. Note that sildenafil can’t be taken by men having drugs containing nitrates and its use requires medical surveillance for possible side effects. Issues such as joint pain and urinary incontinence can eradicate sexual activity and may also be specifically treated.

Being sexually active doesn’t necessarily mean having intercourse. Knowing your partner, listening to his or her needs will allow for a full and satisfying sex life.

Seniors must also concern about safe sex. Advanced age doesn’t elude infections such as syphilis, gonorrhea, chlamydia, genital herpes, genital warts, and HIV. Unsafe sex is responsible for the increase of sexual transmitted diseases. In fact, between 2007 and 2011, chlamydia infections among americans over 65 increased by 31 percent and syphilis by 52 percent. A study published by Jena and her colleges in the Annals of Internal Medicine concludes that HIV is rising among men using erectile dysfunction drugs.

Sexual activity contributes to a good quality of life at any age. Believing that old people lack interest or simply don’t have sex corresponds to a stereotype that shouldn’t exist.

News for future moms: pros and cons of eating fish

On everyone’s mind, fish tops the list of healthy foods. You may even feel a certain amount of unabashed guilt when about to have a bloody, juicy, and luxuriously tasty beefsteak instead of lovely baked pollock. However, some women consider that eating seafood during pregnancy may be harmful and, care aside, there are no reasons for that, considering proper fish choices and avoidance of raw intake.

Fish provides polyunsaturated fatty acids such as omega-3, well known for improving brain development of children. On the other hand, evidence shows that fish exposes consumers to mercury, which may be responsible for neurodevelopment abnormalities among children born to mothers with elevated mercury levels measured in hair samples. This is one conclusion of a study carried out by Koren and Bend, published in the October 2010 issue of Canadian Family Physician.

So, in one hand, you should eat fish during pregnancy to increase the chances of having smarter kids and, on the other hand, you should be careful to avoid neurodevelopment hazards. This raises the 5 million dollars question: how much is recommended and how safe it is at the same time? The US Food and Drug Administration (FDA) and Environmental Protection Agency recently issued recommendations for 8-12 ounces of low-mercury fish. That’s about 2 to 3 servings a week. The list of low-mercury fish includes salmon, shrimp, pollock, tuna (light canned), tilapia, catfish and cod. FDA specifically alerts for the risk of tilefish from the Gulf of Mexico, shark, swordfish and king mackerel as the 4 highest-mercury fish.

Sushi, however, isn’t a good option for pregnant women. Microbes, that are safely neutralized by high temperatures reached with normal cooking, may contaminate raw fish and be harmful during this cautious period.

There’s bad news for fish haters too: supplements of polyunsaturated fatty acids don’t replace seafood intake. There are other healthy nutrients only provided by the real thing.

Benefits of fish eating extend to breastfeeding moms and young children. Actually, they extend to everyone: fish is good for your skin, heart, lungs, eyes, brain… it prevents diabetes, depression, cancer, mental aging… the list of health benefits seems endless.

Question: Supplements and nuvaring

Noname asked:

I am on nuvaring for birth control purposes and I want to start taking saw palmetto supplements but will they affect the effectiveness of the nuvaring?

No.

Question: First trimester bleeding

Steph asked:

Hello one week ago I suffered a miscarriage at 12 weeks . I was cramping then tissue in the size of a finger fell out. No embryo just tissue ? Then after I had a bleeding, like a period for about 6 days. My question is , since I don’t have health insurance, do you think my body naturally miscarried everything ? Bc I feel fine and I have now cramping and the bleeding has subsided.
I want to get checked but I’m waiting to get insurance . I just don’t know how urgent the medical situation is.

 

I don´t have enough information to assess your situation and its urgency. If you were exactly 12 weeks into gestation, the clinical scenario you describe seems incompatible with a complete abortion. By then you’d be entering second trimester, the blood loss should be heavier and you would be able to identify fetal and chorionic tissues. Anyway, I’m assuming that you hadn’t a ultrasonography performed prior to the incident so, with the available data, here are a few scenarios:

  • complete abortion at a earlier gestational age (meaning wrong calculation of gestational age)
  • incomplete abortion (thus, conceptional tissues inside your uterus may still be present)
  • threatened abortion (and you’re still pregnant).
  • an ectopic pregnancy (embryonal development outside the uterus) is less likely but, nevertheless, still a possibility.

The fact that you’re feeling well is a good thing but medical evaluation is mandatory. Until then, I advise you to be on full alert to new symptoms such as abdominal pain, bleeding and fever. I also advise you to avoid sexual intercourses.
Hope this was helpful.