Anonymous on September 28, 2011

I’ve had vaginal bleeding and pain with sexual activity lately...what could be the cause?

My boyfriend and I have been doing some heavy petting…but when he puts his fingers in my vagina, I feel pain and immediate bleeding occurs. I don’t have any pain normally. I think there might be a lump near the vaginal opening. What could this be?

answered by Ruthann M. Cunningham, MD on September 28, 2011

Thanks for your question. I can understand your concern and I’m happy that you’re paying attention to clues about your health.

There are several possible causes of your abnormal bleeding and pain, and I’ll describe a few of them here…but first and foremost, I encourage you to see your doctor for a full examination, diagnosis and treatment, if needed. Whenever a woman has vaginal bleeding that’s unrelated to menstruation, it’s time for a doctor’s visit. 

Just so you know, it turns out that age plays a big role in determining the causes of abnormal bleeding…because you didn’t provide your age, I’ll assume that you’re in your reproductive years in my response. 

One cause of abnormal vaginal bleeding is cervicitis. This is an inflammation of the cervix (at the back of your vagina between the vagina and uterus). Sometimes, but not always, the inflammation is caused by a sexually transmitted disease (STD) like chlamydia, gonorrhea or trichomoniasis; or, it can be caused by a different kind of bacterial infection, like bacterial vaginosis.

Other times, cervicitis occurs after a foreign object (like a tampon or a diaphragm, for instance) irritates the cervix. No matter the cause, when the skin of the cervix is touched in women with cervicitis, the skin can break and can cause abnormal bleeding. Typically, the treatment for cervicitis includes identifying whether the infection is caused by an STD and then administering appropriate antibiotics.

Cervical polyps are another cause of abnormal vaginal bleeding. Polyps are small harmless growths and when they grow on the cervix they can sometimes grow large or begin to bleed. Usually, doctors will leave polyps alone unless they’re larger than three centimeters or if they’re causing abnormal bleeding. If it turns out that you have a polyp that is bleeding, your doctor can remove it with a relatively simple procedure called a polypectomy.

Unfortunately, one more possible cause of vaginal bleeding is cervical cancer. The risk of cervical cancer increases with age, but women can get it at any time. Most cervical cancers have been linked to human papillomavirus (HPV) infection...the longer you have some types of HPV infection, the more time it has to potentially cause cancer.

The good news is that doctors can diagnose cervical cancer and even pre-cervical cancer with a Pap test that examines a small selection of cells taken from your cervix. If it does look like you have pre-cancerous or cancerous cells, you doctor can remove them. Getting treatment as soon as possible can help prevent cervical cancer ⎼ especially when pre-cancerous cells are found early.

These are just a few possible causes of your symptoms…again, only a full examination by a doctor or gynecologist will set you on the path for proper diagnosis and treatment. 

Thank you so much for sharing your question with us, and I wish you good luck and good health. 

Related info:

Ruthann M. Cunningham, MD

Dr. Cunningham is a member of the Analyte Physicans Group. She's also a member of the American College of Emergency Physicians, practicing at both Northwestern Lake Forest Hospital in Illinois and at Wheaton Franciscan All Saints Medical Center in Wisconsin. An ER physician since 2000, she regularly treats patients with STDs. Dr. Cunningham was educated at Wayne State University School of Medicine and completed her Emergency Medicine residency at Cook County Hospital in Chicago, IL.

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