Will sexual intercourse cause bleeding in cases of uterine prolapse?

Written by Shen Li Wen
Obstetrics and Gynecology
Updated on February 06, 2025
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When women suffer from uterine prolapse, bleeding usually does not occur during intercourse. Bleeding only occurs in certain special circumstances, such as when a woman suffers from severe cervical erosion or acute cervical inflammation, where the cervical surface exhibits congestion and edema.

Furthermore, some women with severe symptoms of uterine prolapse might have the cervix protruding outside the vaginal opening; the friction between the cervix and undergarments can lead to local ulcers, and even infections. In such cases, intercourse might cause bleeding from cervical trauma. Generally, the amount of bleeding is relatively small, which may manifest as blood streaks in vaginal discharge.

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Obstetrics and Gynecology
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How to check for uterine prolapse?

Uterine prolapse can be assessed through a vaginal examination to determine the degree of prolapse. Uterine prolapse can be divided into three grades: First-degree mild, where the external os of the cervix is less than 4 cm from the hymenal ring and has not yet reached the hymenal ring; first-degree severe, where the cervix has reached the hymenal ring, and the cervix can be seen at the vaginal opening, which constitutes the first degree. Second-degree mild occurs when the cervix prolapses out of the vaginal opening, but the uterus remains inside the vagina, while in severe cases, part of the uterus prolapses out of the vaginal opening. Third-degree prolapse involves both the cervix and the uterus protruding completely outside the vaginal opening. Once uterine prolapse occurs, it is necessary to seek timely medical treatment at a hospital.

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Written by Xu Xiao Ming
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What causes uterine prolapse?

The most common causes of uterine prolapse can be categorized into three types. The first type is childbirth injury, which is the main cause of uterine prolapse. During childbirth, especially with vaginal surgical assistance or prolonged second stage of labor, uterine prolapse can occur. The second cause is long-term increased intra-abdominal pressure, such as chronic coughing, habitual constipation, prolonged standing, or weightlifting. These factors can contribute to uterine prolapse. The third type involves poor development or degenerative changes in the pelvic tissues. This mainly refers to uterine prolapse due to congenital deficiencies in pelvic floor development. Generally, childbirth injuries are the most common cause.

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How to recover from uterine prolapse?

Uterine prolapse can be classified into first-degree, second-degree, and third-degree prolapse. Typically, first-degree prolapse is considered mild and can generally be managed with a pessary or by performing exercises to strengthen the anal levator muscles and pelvic floor rehabilitation movements, which usually achieve the treatment purpose for mild uterine prolapse. Moderate or severe uterine prolapse must be treated according to the specific condition. In cases of severe prolapse, surgical options can be considered. Common procedures include uterine ligament suspension or vaginal hysterectomy. The treatment for uterine prolapse generally depends on age. For older individuals with severe prolapse, vaginal hysterectomy is often recommended. For younger patients with severe prolapse who wish to return to normal, uterine ligament suspension surgery is generally an option.

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Does uterine prolapse affect pregnancy?

Uterine prolapse, as long as it does not affect sexual intercourse, generally does not impact the ability to conceive. Uterine prolapse can be classified into three degrees. First-degree uterine prolapse does not affect pregnancy since it allows for normal sexual activity. However, in the case of third-degree uterine prolapse, the uterus has prolapsed out of the vagina and sometimes cannot be repositioned, thus interfering with sexual activity and affecting the ability to conceive. Therefore, whether uterine prolapse impacts pregnancy depends on the patient's condition, as well as whether they have normal menstruation or normal endocrine function.

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Causes of uterine prolapse

Uterine prolapse is a common gynecological condition, primarily caused by damage to the pelvic floor tissues during childbirth. As the fetus descends during labor, it can damage the pelvic floor muscles and fascia, leading to a reduction in their supportive strength, which in turn causes the prolapse of the uterus and vagina. Additionally, aging is another main cause of uterine prolapse. As age increases, relaxation of the cervix, various uterine ligaments, and pelvic floor fascial muscles also contribute significantly to uterine prolapse.