Can performance anxiety affect sexual function?

Bleeding after intercourse — postcoital bleeding — always warrants assessment, even when it happens once and settles. The most common causes are benign: cervical ectropion (a normal variant particularly common with hormonal contraception or in pregnancy), cervical or endometrial polyps, infection including chlamydia, and vaginal dryness or minor trauma. The reason it is always assessed is that it can also be a symptom of cervical abnormality, including pre-cancerous change or cervical cancer. This is not the most likely explanation, but it is the one that must be excluded, and it is why this symptom is never treated as trivial. Assessment involves a speculum examination to view the cervix, STI testing, a cervical screening test if you are due or overdue, and usually a pelvic ultrasound. Please book a gynaecology appointment rather than waiting to see whether it recurs — and mention it specifically, as it is easy to leave out. If you are pregnant, contact your obstetrician the same day for any bleeding, as the assessment differs.