Whenever I have rough sex with my partner, I get vaginal bleeding. Should I be concerned?

• Vaginal bleeding after sex can occur for a variety of reasons, including yeast infections, STIs, birth control pills, and cervical cancer.
• For a 20-something woman, gynecologist Dr. Mary Jane Minkin said it likely has to do with how you prepare for penetrative sex.
• Before your boyfriend penetrates you, Minkin suggested engaging in more foreplay to make sure you have enough vaginal lubrication. You could also use lube when you have sex to prevent unwanted friction.
• Have a question for Julia? Fill out this anonymous form. All questions will be published anonymously. You can read more Doing It Right here.

I'm 20 years old, and I started having sex with my boyfriend a few months ago. We have sex about twice each month and most of the time, it's rough vaginal sex.

During sex, I sometimes bleed, but it doesn't feel painful at all and it's a small amount of blood. Usually I stop bleeding once we stop having sex, but I've also noticed a couple of instances where I've continued to bleed (just a small amount) afterwards.

I started to pay closer attention to exactly what we were doing, and noticed that when we have sex more slowly and my boyfriend doesn't penetrate me as deeply that I won't bleed.

Should I be concerned about the bleeding? Could it mean I have a serious medical problem?

- Malaysia

Dear Malaysia,

I'm glad you aren't experiencing any pain during or after sex, but you shouldn't ignore the bleeding you've had.

There are lots of reasons why someone with a vagina could bleed after sex, and the causes range from minor to major health concerns.

According to gynecologist Dr. Mary Jane Minkin, the worst-case scenario is cervical cancer, but for someone your age, the culprit is likely something more minor and easily solvable.

Minkin told me chronic yeast infections, which occur when there's an overgrowth of bacteria in your vagina, could cause irritation in the form of tears and sores in the vaginal tissue. Those irritations could be made worse, and potentially lead to bleeding, when you have penetrative sex.

Vaginal bleeding could also be a symptom of another type of vaginal bacterial infection, a urinary tract infection, or an STI. If in addition to bleeding after sex your vagina feels itchy, painful, or you have unusual discharge, you should see your doctor.

You also mentioned that you and your boyfriend tend to have rough sex. Minkin said that type of action could lead to bleeding if you aren't properly aroused beforehand. Often, a lack of foreplay before penetration is to blame for too little vaginal lubrication, and friction that can lead to bleeding down there.

"So if you have somebody who's fairly dry to begin with, because there's been pretty little foreplay for her and he starts majorly thrusting, you can end up with some irritation, because the dryness isn't just so much her native dryness, but she's not getting enough arousal time to moisturize her vagina appropriately," Minkin told me.

If focusing on foreplay doesn't seem to solve the problem, you could add lube to your routine for extra moisture, Minkin said.

Your birth control could also be the problem, according to Minkin, because low-estrogen birth control pills can often cause vaginal dryness. If you're taking a low-estrogen pill and notice consistent vaginal dryness, it wouldn't hurt to speak with your doctor, who could suggest other pills that better suit your body.

If you spend more time getting aroused, and rule out other culprits like an infection or your birth control but keep bleeding during sex, Minkin said it could be a sign of cervical cancer. This is most common in women between the ages of 35 and 44, and rare in 20-somethings like you, so I wouldn't worry too much about that.

For now, focus on slowly easing into each sexual experience you have with your boyfriend and telling him what feels good for you. See if those slight tweaks make a difference. From there, you can decide on next steps.

Sex should be fun, and by listening to and taking care of your body, I know you can get there.

As Insider's resident sex and relationships reporter, Julia Naftulin is here to answer all of your questions about dating, love, and doing it — no question is too weird or taboo. Julia regularly consults a panel of health experts including relationship therapists, gynecologists, and urologists to get science-backed answers to your burning questions, with a personal twist.

Have a question? Fill out this anonymous form. All questions will be published anonymously.

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