Is It Normal to Bleed After Sex, And What Should I Do About It?

Bleeding after sex can be unexpected, confusing, and even frightening. Maybe it’s a few drops of pink on the sheets. Maybe it feels more like spotting. Or maybe you weren’t sure it was even related to sex until it happened a few times in a row.

If you've found yourself wondering, “Is this normal?” or “Is something wrong with me?” you’re not alone and you're not overreacting.

Many of our clients come to therapy carrying uncertainty around what they’re experiencing in their bodies, especially when it comes to things like sexual pain, discomfort, or bleeding during or after sex. These symptoms are often dismissed or minimized, and that can leave people feeling isolated, ashamed, or unsure of what to do next.

Let’s talk about what post-sex bleeding can mean, when to seek medical care, and how sex therapy can support you emotionally, relationally, and sexually.

Is Bleeding After Sex Common?

In short: yes, it’s relatively common, but that doesn’t mean it should be ignored.

The medical term for bleeding after penetrative sex is postcoital bleeding. Studies estimate that up to 9% of menstruating people experience it at some point. It can happen to anyone regardless of your age, sexual orientation, gender identity, or relationship status.

Postcoital bleeding can happen after:

• Vaginal or anal penetration

• Use of sex toys or fingers

• A new sexual partner or different position

• Rough or prolonged intercourse

• Sex after a long period of abstinence

Whether you’re in a long-term relationship, exploring a new connection, dating casually, or single and reconnecting with your body, this experience is valid, and deserves attention.

What Causes Bleeding After Sex?

Bleeding can be caused by several different factors. Some are minor and temporary, while others may require medical attention.

Vaginal Dryness or Lack of Arousal

If your body isn’t fully lubricated, penetration can cause small tears in the vaginal walls, leading to light bleeding. This can happen if you’re not fully aroused, feeling anxious, or navigating hormonal changes (like postpartum, perimenopause, or the effects of certain medications).

Cervical Sensitivity

Some people have a cervix that is naturally more sensitive or lower in position, making it more prone to bleeding with deeper penetration or certain positions.

Friction or Rough Sex

Even if sex is consensual and pleasurable, higher-intensity or prolonged penetration can irritate delicate tissue. Using toys, strap-ons, or fingers for penetration may be related if there’s not enough lube or warm-up.

Infections

Sexually transmitted infections (STIs) like chlamydia or gonorrhea can cause inflammation and increase bleeding. Bacterial vaginosis or yeast infections may also lead to irritation and spotting.

Polyps or Cervical Changes

Non-cancerous growths on the cervix or uterus (like polyps or fibroids) can cause bleeding during or after sex. In some cases, cervical cell changes due to HPV or other conditions may also lead to spotting.

Trauma or Injury

Unintentional tearing of the vaginal or anal tissues can happen during sex, especially if there’s inadequate preparation, insufficient lube, or communication challenges about pacing and comfort.

When to See a Medical Provider

While occasional light spotting isn’t always a cause for concern, consistent or heavy bleeding after sex should always be evaluated by a provider.

You should reach out to a medical professional if you:

• Bleed after sex regularly

• Notice pain, burning, or discomfort

• Experience bleeding outside of your menstrual cycle

• Have discharge, odor, or other new symptoms

• Haven’t had a recent pelvic exam or STI screening

Our team of sex therapists can also connect you with a gynecologist or primary care provider you trust. Queer-friendly and trauma-informed providers are available, and your experience deserves to be taken seriously, without shame or dismissal.

Emotional and Relational Impacts of Post-Sex Bleeding

Beyond the physical symptoms, bleeding after sex can take a toll on your mental and emotional well-being. Many of our clients describe feeling:

• Embarrassed or ashamed

• Afraid to initiate or enjoy sex

• Distant from their partner(s)

• Anxious about being “too much” or “not normal”

• Reluctant to talk to providers for fear of judgment

This is where relationship therapy can be a powerful part of your support system.

How Sex Therapy Can Help

We offer a compassionate, affirming space to process what you're experiencing, whether you’re dealing with physical discomfort, relational tension, or emotional blocks.

Here’s how sex therapy can support you:

Unpack the Emotional Impact

You might logically know bleeding is common, but still feel embarrassed, anxious, or frustrated. Therapy helps you explore those feelings and reduce the shame that often keeps people silent or disconnected.

Address Fear and Avoidance

It’s common to start avoiding sex or intimacy out of fear that you’ll bleed, hurt, or upset your partner. In therapy, we work to understand and gently shift these patterns so you can reconnect with your body on your terms.

Improve Communication

Whether you’re partnered or dating, or even preparing to explore intimacy again, therapy can help you communicate your needs and boundaries more confidently, without apologizing for your body.

Explore Queer-Affirming, Inclusive Sexual Health

If you’re queer, non-monogamous, or nonbinary, your experience matters. We understand that your sexual health concerns may not fit into a traditional framework, and we’re here to hold space for the full spectrum of identities, relationships, and practices.

You Are Not Alone And You’re Not Broken

Your body is speaking to you. Bleeding after sex may not always mean something serious, but it is always worth exploring. Whether you're concerned, confused, or just want to feel more confident navigating sex and intimacy; it’s okay to ask questions and seek care.

If you're looking for support that goes beyond a quick Google search, or you've ever typed “sex therapist near me” hoping to find someone who gets it, know that you're in the right place.

Support Is Available

At Embrace Sexual Wellness, we specialize in working with people of all orientations and relationship styles who are navigating issues like discomfort during sex, low desire, performance anxiety, and intimacy after physical or emotional pain. We’re based in Chicago, IL, and also serve clients virtually in Illinois, Indiana, Idaho, Kansas, and Louisiana.

Whether you’re partnered, single, newly dating, queer, or questioning, your experience is valid, and your body deserves care. Book a free phone consultation with us today!

How Guided Imagery Can Improve Your Sex Life

When it comes to enhancing your sex life, most people think about communication, hormones, or maybe even positions. But what if a powerful and underutilized mental tool could help you reconnect with your body, enhance arousal, and reduce performance anxiety? That’s where guided imagery comes in.

As trusted relationship and sex therapists, we often integrate guided imagery into treatment plans to help individuals and couples strengthen intimacy, feel more confident in their bodies, and safely explore desire. Whether you're experiencing low libido, sexual trauma, or disconnection from your partner, guided imagery can be a powerful pathway to healing and pleasure.

What Is Guided Imagery?

Guided imagery is a mind-body technique that uses mental visualization to promote physical, emotional, and psychological well-being. Typically practiced with a therapist or through self-guided exercises, this method involves imagining scenarios designed to elicit calm, pleasure, or healing.

In sex therapy, guided imagery focuses on cultivating arousal, reducing anxiety, healing from past trauma, and deepening emotional connection. By tapping into the imagination, people can safely explore their sensuality and rewire unhelpful thoughts about intimacy.

The Science Behind Guided Imagery and Sexual Wellbeing

Guided imagery is not just creative daydreaming—it’s backed by science. Neuroimaging studies show that the brain responds to imagined experiences in ways similar to real ones. When used regularly, guided imagery activates neural pathways related to relaxation, pleasure, and even motor function, making it a powerful tool for addressing sexual issues. A systematic review of the literature suggests mindfulness-based interventions can improve sexual desire and arousal in women with low libido.

A 2023 study found that guided imagery interventions significantly reduced anxiety symptoms and improved the quality of life in patients with anxiety disorders. This suggests that guided imagery can be an effective tool for managing anxiety, which is often linked to sexual dysfunction.

How Guided Imagery Can Help Your Sex Life

Reduces Performance Anxiety

Performance anxiety can affect people of all genders and orientations. Whether you're concerned about reaching orgasm, maintaining an erection, or meeting a partner’s expectations, anxiety disrupts the natural rhythm of intimacy.

Guided imagery promotes relaxation and self-trust by allowing the brain to "practice" scenarios in a safe, low-pressure environment. Visualization exercises that focus on confidence, touch, and pleasure can help desensitize the nervous system and break the cycle of fear.

A 2024 study in the Journal of Education and Health Promotion demonstrated that music-guided imagery can improve sexual dysfunction for women. The intervention led to enhanced desire, arousal, and orgasm, indicating that guided imagery can effectively reduce performance anxiety and improve sexual functioning.

Builds Body Confidence

Many individuals struggle with body image issues that interfere with sexual satisfaction. Negative self-perception can lead to avoidance, self-consciousness, or disconnection during intimate moments.

Guided imagery can challenge those beliefs. By visualizing your body as strong, sensual, and worthy of pleasure, you begin to shift your inner dialogue.

A 2023 pilot study published in the Journal of Sexual Medicine found that a virtual, group-based mindfulness intervention for midlife and older women with low libido led to significant reductions in sexual distress. While the study focused on mindfulness, it highlights the importance of mental practices in enhancing sexual well-being, which can be complemented by guided imagery techniques.

Reconnects You to Desire

Life stressors, medical issues, parenting, and relational tension can all dull desire. When arousal feels out of reach, guided imagery offers a way to reconnect with what turns you on without pressure or expectation.

Imagining sensual experiences that evoke warmth, curiosity, or eroticism can reignite the internal spark many clients report losing over time. In fact, guided imagery is one of the most empowering tools we offer in sex therapy when clients seek support for low libido or desire discrepancy in their relationships.

Research suggests that using sexual imagery strategies with a long-term partner may increase desire and infatuation. This indicates that guided sexual imagery can be a helpful strategy for couples to enhance their sexual connection and desire.

Heals Sexual Trauma

Survivors of sexual trauma may struggle with dissociation, fear, or discomfort during intimacy. Guided imagery creates a safe internal space where individuals can explore sensations and touch on their own terms, with full control over the experience.

Through consistent practice, guided imagery can help build new neural associations between sex and safety, reclaiming pleasure as a choice rather than a threat. While more research is needed, guided imagery has shown to be helpful for many health conditions including stress, fatigue, chronic illness, depression and anxiety.

Improves Emotional and Erotic Connection

Couples can also benefit from guided imagery, whether practicing it together or individually. Visualizing emotional closeness, intimacy rituals, or even shared fantasies can reignite erotic energy and deepen connection.

Mindfulness-based therapy practices, including guided imagery, can significantly enhance sexual experiences by helping individuals stay present and focused during sexual activity. Techniques like using positive mental images can influence individuals’ emotional experience, enhance self-awareness, and improve sexual arousal and desire. Accessing imagination and fantasy through guided imagery may increase pleasure and promote positive attitudes about sex.

In sex therapy sessions, we encourage partners to use imagery as a bridge to more open conversations about desire, boundaries, and pleasure. Even just five minutes a day can shift the emotional tone in a relationship.

How to Practice Guided Imagery at Home

Exploring guided imagery doesn’t have to be complicated. In fact, practicing at home can enhance your results when combined with therapy or serve as a great standalone practice.

Here’s how to begin:

Step-by-Step: Solo Guided Imagery for Sensual Connection

• Set the Space. Choose a quiet, comfortable environment where you won’t be interrupted. Use soft lighting or calming music if it helps.

• Focus on Breath. Sit or lie down, close your eyes, and take a few deep, slow breaths. Let your body settle.

• Create Your Scene. Picture yourself in a place that feels sensual, safe, and peaceful—a beach at sunset, a luxurious bath, a soft bed.

• Engage Your Senses. What do you see, hear, smell, feel? Imagine your body relaxed, warm, and open to sensation.

• Add Gentle Touch (Optional). Lightly touch your arm, neck, or chest in a way that feels comforting or arousing. Breathe into the sensation.

• Invite Desire. Think of an erotic or intimate scenario that brings pleasure. Let it unfold slowly. You’re not performing—you’re exploring.

• Return Gently. When you're ready, slowly bring yourself back to the present. Reflect on what you felt and learned.

Practice this a few times per week to start building new pathways between your imagination, body, and arousal response.

Guided Imagery Apps and Tools

If you prefer structured guidance, several apps and recordings can support your practice:

• Insight Timer – Free meditations, including sensual and body-based imagery

• Sexual Mindfulness by Dr. Lori Brotto – Evidence-based resources for sexual healing

• Calm – Though not specifically erotic, many sessions focus on embodiment and self-connection

• Headspace — Free guided meditations and techniques

These tools can help you establish a regular practice and deepen your connection to your body and desires.

Ready to Explore Guided Imagery in Therapy?

Guided imagery is just one of the many tools available to help you live a fuller, more connected sex life. Whether you’re facing challenges around desire, trauma, or relationship dynamics, working with a trained sex therapist can make a profound difference.

Nurturing Sexual Intimacy: Rediscovering Connection After Cancer Treatment

Embarking on the journey of a cancer diagnosis and subsequent treatment is undoubtedly a challenging road that can impact intimate relationships. The process of re-establishing sexual intimacy after cancer calls for a thoughtful approach—one grounded in understanding, open communication, and patience. In this article, we'll delve deeper into the potential effects of cancer on sexual health, discuss specific resources available, and provide detailed insights on how to approach the gradual process of rebuilding intimacy when the time feels right.

Understanding the Impact of Cancer on Sexual Functioning

Cancer and its treatment introduce physical changes that can significantly affect sexual functioning. Surgical procedures may alter body structures and tissues, and chemotherapy or radiation therapy can induce fatigue, pain, vaginal dryness and hormonal imbalances. Beyond the physical side effects, the emotional toll of a cancer diagnosis, marked by anxiety, depression, and uncertainty, can cast a shadow on libido and overall sexual well-being. It's important for individuals and their partners to grasp the nature of these changes and engage in open communication with healthcare providers, including oncologists, nurses, and specialists to gain valuable insights into managing these challenges effectively.

How do I support my intimate partner during cancer treatment?

Approaching intimacy after cancer treatment requires support from all individuals in a relationship. Here are considerations for the supportive partner:

Open Communication

Open communication serves as the cornerstone of navigating this sensitive terrain. Creating an environment where both partners can freely express their feelings, concerns, and desires is crucial. Encouraging your partner to share their experiences and being attentive to their emotional needs fosters a deeper understanding and connection.

Self-Educate

Taking the initiative to educate yourself about the potential physical and emotional changes resulting from cancer treatment is a proactive step. This knowledge equips you to provide informed support and navigate the journey together, demonstrating a commitment to shared understanding.

Practice Patience

Recognizing that rebuilding intimacy takes time is essential. Being patient with your partner and acknowledging that the process may involve ups and downs is key to fostering a supportive environment. Understanding that your partner's feelings and needs may evolve allows you to adapt your support accordingly, creating a foundation for resilience and growth.

Find your own support

Participating in counseling sessions or support groups as a couple is a collaborative approach that can strengthen the bond between partners. This shared experience enhances communication and provides practical tools to navigate the unique challenges that may arise in the aftermath of cancer treatment. Encouraging your partner to seek guidance from healthcare professionals, therapists, or sexologists who specialize in post-cancer intimacy is a proactive step toward holistic support. Professional guidance can offer tailored strategies and insights to address specific challenges, empowering both partners on the journey of rediscovering intimacy after cancer.

How do we approach intimacy after cancer?

Rebuilding intimacy necessitates a deliberate and patient approach. Open communication serves as the cornerstone of this process, where partners express their feelings, fears, and desires, fostering mutual understanding and empathy. Taking it slow is crucial. Initiating non-sexual forms of physical connection, such as cuddling or holding hands, can create a foundation for rebuilding intimacy at a pace comfortable for each partner.

Exploring sensate focus, a technique employed by sex therapists involves non-demanding, pleasurable touch without the expectation of sexual activity. This approach encourages partners to reconnect on a physical level, fostering a renewed sense of intimacy without the pressure of immediate sexual expectations.

Lastly, educating oneself about the potential physical and emotional changes resulting from cancer treatment is empowering. Understanding these changes reduces anxiety and contributes to a more supportive and empathetic relationship, with resources such as reputable websites, books, and pamphlets provided by healthcare professionals in the Chicagoland area offering valuable insights.

Resources for Cancer Support in Chicagoland

• American Cancer Society: The American Cancer Society (ACS) is a vital support system for cancer patients, providing easily accessible information on different types of cancer, current treatments, and resources. Through initiatives like Relay For Life and educational programs, ACS promotes cancer awareness and fundraising for research. ACS also offers support services, such as transportation assistance and lodging for patients undergoing treatment. With a focus on community engagement and advocacy, the American Cancer Society plays a crucial role in supporting and empowering individuals affected by cancer.

• Cancer Treatment Centers of America (CTCA) - Chicago: CTCA is dedicated to cancer care and offers a comprehensive approach to address the physical and emotional aspects of cancer treatment. They provide specialized support services and access to healthcare professionals well-versed in managing the unique challenges of post-cancer intimacy.

• Cancer Wellness Center: Through supportive care and education, the Cancer Wellness Center seeks to improve the emotional and physical well-being of people affected by cancer. It is located in Northbrook, IL and all of their virtual and in-person programs are offered free of charge. Programs include support groups, counseling/therapy, educational programs, exercise and physical wellness programs, nutritional counseling, mind-body practices, and a resource center.

• Gilda's Club Chicago: Gilda's Club is a community organization providing support and education to individuals and families impacted by cancer. They offer counseling services, support groups, and educational programs that address the emotional aspects of rebuilding intimacy.

• National Cancer Institute: The National Cancer Institute (NCI) is a crucial resource for cancer patients, offering easy-to-understand information on various cancers and access to the latest treatments through clinical trials. NCI is dedicated to supporting patients by providing educational materials and promoting cancer prevention initiatives. With a focus on collaboration and patient-centered care, NCI plays a vital role in offering valuable support and fostering hope within the cancer community.

• Northwestern Medicine Cancer Center - Chicago: Northwestern Medicine's Cancer Center in Chicago is renowned for its multidisciplinary approach to cancer care. The center provides access to oncologists, psychologists, and counselors who can offer guidance on managing the effects of cancer on sexual health.

• University of Chicago Medicine Comprehensive Cancer Center: This center is a hub for cutting-edge cancer research and treatment. The Comprehensive Cancer Center offers support services and resources to help individuals navigate the challenges of post-cancer intimacy, including counseling and educational programs.

• Wellness House - Hinsdale: Wellness House provides a variety of programs and services to support individuals and families affected by cancer. Their offerings include counseling, support groups, and educational workshops aimed at addressing the emotional and relational aspects of post-cancer life.

TLDR

Re-establishing intimacy after cancer treatment is a personal journey requiring patience and understanding. Partners can play a crucial role by fostering open communication, educating themselves about post-cancer changes, attending support sessions together, being patient, and encouraging professional guidance. Remember, the path to rebuilding intimacy is gradual, and prioritizing emotional connection lays the foundation for a fulfilling post-cancer sexual relationship.