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blood in urine after sex

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I had intercourse 2 weeks ago, right after my period. The day after intercourse, I noticed blood in my urine. This has been happening ever since, and especially during intercourse. Otherwise, there is not blood throughout the day. I have a 10 yr, non-hormonal IUD. I had a clean pap a few months ago, I recently tested negative for all STDs and so has my partner. I have no pain, but very slight, mild period-like cramps. The blood is bright red, and like I said, there is A LOT of it during intercourse. There is a small amount of blood if I use a tampon, but it is not as saturated as it would be during my period. During intercourse, there is more blood than during menstruation.

A few additional things... I think it is odd it happened so soon after intercourse. It was the first time I had had intercourse in about a month. My friend in PA school said she was taught blood in urine without pain is cancer, but I feel like it was prompted by intercourse. I frequently lift heavy weights for exercise. I have a healthy diet, drink over a gallon of water/day. Per my online research, I think I may have a hemangioma. Could a loose IUD cause this much bleeding? I have checked and felt the IUD still secure. From here, I would like to know whether to see a urologist or gyno.

Category: Internal Medicine Specialist

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Category: Family Physician-GP
Dr. John Fuller is online now

Expert:  Dr. John Fuller replied 4 Days.

Thank you for using Ask a Doctor Service from Doctor Spring.
I can understand your problem and will try to help you the best possible.

Bleeding after intercourse can occur for several reasons. When you have an IUD, however, bleeding after intercourse may mean that the IUD has moved from the top of the uterus to the lower part, which may render it ineffective. So you could use an alternative method for contraception, until you get it confirmed from your doctor that IUD is in the correct place it should be. Another cause for such bleeding is Infection.  Anything from a yeast infection to a sexually transmitted disease like gonorrhea or chlamydia can irritate the cervix to the point where trauma from sex can lead to bleeding. However, you have mentioned that you have been tested for STD, and it was negative, it is less likely to be the cause. Next possible cause is benign polyps of the cervix (small projections of tissue) that may also bleed from the friction caused by sexual intercourse. Sometimes, if your vagina is too dry, then a sexual intercourse can cause tears in vagina causing fresh bleeding. So, firstly, it is important to make sure that IUD is in place, because if it is displaced a little, it can cause more serious problem. Consult with a Gynaecologist, the doctor will examine for the position of IUD and correct it if possible, or remove it and advise you for alternative method for contraception. And a gynaecologist will also be able to check for any lesion in the cervix or vagina causing bleeding such as polyp, erosion, tears and infection. Polyps can be detected and removed. If a tear is found, usually lubricants or changes in style of intercourse will be recommended. In any case, you must not ignore bleeding after intercourse, especially if it happens repeatedly. So I would recommend you to consult with a Gynaecologist, and sort out this problem. It is very likely to be a cancer or hemangioma, since you’ve had a clean pap few months ago, it almost rules out cancer. You can repeat pap, if you have done it before more than two months’ time, otherwise it is not necessary. It is not a very serious problem so do not panic. I would recommend you to consult with a gynaecologist to further diagnose and treat this problem.

Hope this helps. Feel free to ask if you have further queries. Thank you.

Dr. John Fuller
Category: Family Physician-GP
MD - New York Institute of Technology, New York College of Osteopathic Medicine
Internship, Family Medicine - Lutheran Medical Center
Residency, Family Medicine - The Mount Sinai Hospital
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