Bleeding Durring Intercourse

Hello Doctor,

I have had a history of STD's with the same partner, and I have asked questions here before regarding these earlier instances, but I'm worried again.  I'll try to make the history quick: i had unprotected sex a few months before dating my g/f, and after 4 months I was told I had mulloscum cont, and was told i was neg for other STDs.  In october '07, my girlfriend was experiencing bleeding after sex and between her periods.  I was experiencing pain after ejaculating, but I didn't associate it with anything... She went to her gyno and was told we had chlamydia and HPV.  We were treated for chlamydia, she was told to check back in a year. I was not tested at this time, but in feb '08 i was feeling weird so i went to the my GP to get checked. neg for chlamydia. (went back twice because i was still experiencing symptoms, but was ultimately told i was fine and to try and see if the symptoms were in my head: symptoms went away...)

Last night after having sex, we noticed that my girlfriend was bleeding and had bled enough to drip out onto the bed.  This has happened the past few times we have had sex, but the days were close to her period and so we just thought "oops".  Last night i was worried since this continues to happen and is similar to what had happened previously. We haven't really had sex too often lately, but I'm not sure if this is just a fluke... She also mentioned that when we first started it was a little uncomfortable as she was not quite ready, and the only lube was what was on the condom.

Could this be related? Should we see a doctor sooner? We have not been with other partners... We use condoms only for B/C since we are monogamous and already share HPV...

Is there any particular questions we should ask her Dr. or symptoms to look for? Thanks so much! I appreciate all of the posts and advice both Dr. Handfield and Dr. Hook have given - and it has helped me get through all of this! Thank you.

[H. Hunter Handsfield, M.D.]

Welcome back to the STD forum.  I'll try to help.  The bottom line is that I doubt any STD is going on here.  As you will recall, that was Dr. Hook's opinion when you asked many of the same questions on the forum last May.  And since you and your partner are monogamous and you have been tested, it isn't possible that a new STD is involved.

There are many causes of vaginal bleeding, including bleeding after sex.  STDs, including chlamydia, are among the causes, but in general STDs are less likely causes than numerous other conditions.  One possibility, which could be STD related, comes back to your apparently shared HPV infection:  certain HPV lesions of the cervix might bleed.  Whatever the cause, bleeding often is triggered by sex, so that part of the history doesn't help much.

Any unexplained vaginal bleeding should be investigated, so your partner should see her health care provider about it, as you apparently are planning to do.  Depending on what is found on examination, her doctor might test for certain STDs, but except for the possibility of an HPV related cervical problem, there is nothing in your story particularly suspicious for STD.  I have no particular recommendations for her doctor.  Any gynecologist knows more about the causes of vaginal bleeding than Dr. Hook or I do; STD experts don't generally deal with this sort of problem; gynecologists do.

Feel free to return to the forum to report her doctor's diagnosis, especially if it turns out to be STD related.  But I doubt it will.

Regards--  HHH, MD