Sexual Health

Yes, it is safe to have sex when you have a bleeding disorder if you take necessary precautions.

There are different ways to have sex. Some examples include vaginal sex, oral sex, anal sex, fingering, hand jobs, dry humping or genital rubbing, masturbation and the use of sex toys or devices. Remember that a bleed can happen anywhere the blood flows. Sex can involve parts of the body that have a lot of blood vessels, including the mouth, genitals, and anus.

It’s important you work with your partner(s) to find out what works best for you. You can use pillows or blankets to give extra support if needed. The most important thing is to only do what you and your partner(s) feel comfortable doing. Communicate to make sure the sex is consensual (agreed upon by both people) and establish respect and boundaries.

Remember that having sex comes with risks, such as an unplanned pregnancy or getting a sexually transmitted infection (STI).  It is important to take precautions to be safe. Using condoms and internal condoms correctly can protect against STIs. If you are concerned about getting an STI, talk with your health care provider or find a location near you to get tested.

Sex is like most other strenuous physical activities for people with a bleeding disorder. It can cause a bleed in any part of the body including muscles or joints.

Some parts of the body are particularly vulnerable to bleeds during and after sex. The signs and symptoms may not be visible immediately. Some more common ones include bruises or hematomas, muscle bleeds in the calf or forearm, or a joint bleed. Signs of bleeding can include pain, limited movement and swelling.

Those who have a penis should look out for injuries marked by external bleeding, swelling, pain, and discolored urine. Penis bleeds can be serious.

Sex may increase the risk of internal bleeding in the deep pelvic muscles, which may be hard to recognize. After sex some may experience lower back, abdominal, pelvic, groin and/or upper thigh pain. Some may feel numbness and tingling in the affected thigh if they bleed into their deep pelvic muscles. Many are unable to straighten their leg while laying down or stand up straight. These bleeds are commonly called iliopsoas bleeds. With bleeds into your deep pelvic muscles there is a risk of artery, vein, and/or nerve damage. This is due to compression of these structures by the swollen muscle. The nerve damage can be permanent if not treated promptly. Deep pelvic muscle bleeds can be limb and/or life threatening and should be considered a medical emergency.

For women and those with the potential to menstruate, even those without a bleeding disorder, vaginal bleeding during and after sex is not uncommon. If you have ongoing vaginal bleeding lasting a couple of days or needing more than two pads or tampons a day, you may need additional treatment to support your body.

If you experience an injury during sexual activity, stop the sexual activity immediately., Follow your usual medical regime or treatment plan and talk with your Hemophilia Treatment Center (HTC) or health care provider.

The risk is about the same. Any physical activity can potentially cause a bleed, including non-penetrative sex. See the section above for tips.

Yes, you can have sex during your period. What’s most important is that you and your partner(s) are both comfortable with the idea. Penetrative sex can result in increased bleeding. Remember that it’s still possible to become pregnant or get an STI while you are menstruating.

Many women and those with the potential to menstruate with bleeding disorders have periods that last for multiple weeks. Avoiding sex during your period would greatly restrict your sex life. However, depending on your partner(s), it may take some conversations and compromise for everyone to be comfortable with the idea of sex during your period. Experiment with different positions, try having sex in the shower, or use dark towels. Your partner(s) and you should commit to having a sex life that is fulfilling and enjoyable.

You may be using hormonal therapy to manage heavy menstrual bleeding. There are several different methods, such as birth control pills or IUDs (intrauterine devices) available. With each method, make sure you understand and follow the directions. For example, you may need to take your medication every day at the same time for it to be effective. If you are not being consistent, you may become pregnant or have increased heavier periods. Talk with your health care provider, and they can help you select the best option for you.

You can consider other sexual activities for you and your partner(s). You can also engage in intimate activities with your partner like sensual massage or cuddling. Connecting doesn’t have to involve sex. If you’re in pain, tell your partner(s).

For most people sex and intimacy is a big part of their overall well-being. Communication with your partner(s) will help you maintain a safe and healthy sex life. And remember, it is okay to ask any questions or bring any concerns to your health care provider.

Masturbation, having sex with yourself and often by yourself, is completely natural. Making sure nails are cut and lube is used can decrease friction and your chance of causing an injury. Bleeding in the forearm, wrist, and genitals is possible. You may also have a bit of blood in your ejaculate or urine after masturbation. Urine should be clear the next time you pee. If you have ongoing pain, swelling, or blood in your urine, talk with your HTC or your health care provider.

No, your risk of contracting an STI is not higher because you have a bleeding disorder. However, regardless of your bleeding disorder, it is important to practice safer sex to decrease your risk of contracting an STI. Read below for more information on how to practice safer sex.

It is normal to be nervous or feel a bit awkward about bringing up the topic of sex with anyone, including your health care provider or HTC team. They are used to having conversations about sex. Health care providers can answer your questions professionally and keep the discussion confidential. They are one of the best resources for information about the impact that your bleeding disorder has on your life. But sometimes bringing it up can be difficult.

At the beginning of your appointment, tell your health care provider that you have some questions for them. If you let them know at the beginning of the appointment, it can make it easier to start the conversation. If you wait too long, it may be harder to ask the questions. It can be helpful to write your questions down before your appointment. This serves two purposes. You won’t forget the questions and if you’re having difficulty getting the words out, you can always have your health care provider read the questions. The most important thing is that you get your questions answered! Social workers at your HTC are another great resource if you have questions about sex.