My Sister's Keeper 2007

Here is something I found that may interest some of you. It is answered by Frederick R. Jelovsek MD on wdxcyber.com. Hope it helps someone out there. Tahira __________________________________________________ Bleeding after intercourse Lately I have started bleeding after having intercourse, I had an infection a few weeks ago and now the lining of my vagina seems very thin and it hurts to have sex and then I bleed. I am 39 years of age and I have had two children. They are aged 18 and 20. Bleeding after intercourse (post coital bleeding) usually means either the skin lining the cervix or vagina is thin or inflamed, or there is an anatomical lesion on the cervix such as a polyp or a precancerous or cancerous lesion. A normal Pap and pelvic exam within the last year makes cancer highly unlikely, but precancerous lesions (abnormal pap smears, dysplasia) are possible so a physician's visit is indicated with any post coital bleeding. At the time of a visit, in addition to a PAP smear, the physician should be able to tell if there is an anatomical lesion causing the bleeding or if the vagina is thin due to low estrogens and just gets irritated with intercourse. The thinness of the vaginal skin and pain with sex indicate the lining of the vagina may be the likely problem. It sounds as if there are low estrogens such as may be seen in menopause or with the absence of ovulation due to other non menopausal causes. A history of infection may be related or an independent event. If the vagina skin (epithelium) is thin and atrophic, the infection can be a bacterial vaginitis known as atrophic vaginitis. Infections can be other etiologies however, so more information about that would be helpful. Age 39 is quite young for menopause so the recent menstrual history would help too. Many things such as medications, diseases, stress etc., can suppress ovulation which in turn causes low estrogens, which in turn causes atrophic vaginitis, which in turn causes painful sexual relations and sometimes bleeding after sexual relations. The physician may order a serum follicle stimulating hormone (FSH) to rule out menopause and possibly a thyroid stimulating hormone (TSH) and serum prolactin to investigate the possibility of a central nervous system cause of the blocked ovulation. In summary, the problem you describe may not just be a simple infection problem. It can be a symptom of other bodily changes that bear investigating. You shouldn't have to fear having sex!