Based on NIH | Can taking aspirin increase the risk of bleeding during sex?

Aspirin can raise bleeding risk in general, which may make bleeding during sex more likely in some situations. Aspirin reduces platelet function (the blood’s clotting “first responders”), so cuts, mucosal irritation, or friction-related micro‑tears can bleed more and take longer to stop. ^[1] Because this effect is body‑wide, any activity that can cause minor tissue trauma like sexual activity can, in some people, lead to more noticeable bleeding (for example, vaginal spotting, post‑coital bleeding, penile or anal mucosal bleeding). ^[2]

How aspirin affects bleeding

• Aspirin is an antiplatelet medicine; it “thins” the blood by stopping platelets from clumping, which increases bleeding risk. ^[1] This risk is higher if combined with other NSAIDs (like ibuprofen or naproxen), blood thinners, steroids, or with heavy alcohol intake. ^[1]
• Product labeling for both low‑dose and regular‑strength aspirin warns about serious bleeding, particularly gastrointestinal bleeding, and lists factors that raise the risk. ^{[3] [4]} While labels emphasize gut bleeding, the antiplatelet effect can contribute to heavier bleeding at other sites, including the genitals if there is tissue irritation or lesions. ^[3]

When bleeding during sex is more likely

• Pre‑existing mucosal irritation or lesions: cervical or vaginal inflammation, hemorrhoids, anal fissures, or penile skin cracks may bleed more on aspirin. ^[2] Unexpected vaginal bleeding or unusually heavy periods are known warning signs to watch for when on aspirin. ^[2]
• Low platelet conditions or cancer‑related thrombocytopenia: guidance for low platelets specifically advises avoiding aspirin because it can worsen bleeding, and also suggests gentler sexual activity and lubrication. ^[5] If platelets are already low, the added antiplatelet effect of aspirin can raise the chance of bleeding with intercourse. ^[5]
• Drug and alcohol combinations: using aspirin with other NSAIDs, anticoagulants (e.g., warfarin, DOACs), antiplatelets (e.g., clopidogrel), certain antidepressants, or frequent alcohol increases bleeding risk. ^[6] These combinations can make even minor sexual micro‑trauma bleed more. ^[6]

What the evidence shows

• Medical references for aspirin consistently list unusual bleeding such as heavy menstrual or unexpected vaginal bleeding as possible side effects. ^[2] Although research focuses most on gastrointestinal and intracranial bleeding, the same antiplatelet effect can present as mucosal bleeding elsewhere, particularly where friction is involved. ^{[3] [2]}
• The overall bleeding risk with low‑dose aspirin is real but varies by dose, age, ulcer history, and other medicines. ^[1] Using the lowest effective dose and avoiding risky combinations can reduce the chance of problematic bleeding. ^[1]

Practical tips to lower bleeding risk during sex

• Use water‑based or silicone‑based lubricants to reduce friction and micro‑tears. ^[5] Gentler positions and avoiding strong thrusting can also help, especially if you’ve noticed spotting before. ^[5]
• Avoid combining aspirin with other NSAIDs unless a clinician advises it. ^[1] Limit alcohol and check with your clinician before adding medicines that affect clotting. ^[6]
• If you have a history of abnormal vaginal bleeding, heavy periods, genital lesions, hemorrhoids, or low platelets, discuss aspirin use with your clinician. ^[2] Sudden unexpected vaginal bleeding or unusually heavy menstrual bleeding while on aspirin is a reason to seek medical advice. ^[2]

When to seek care urgently

• Large amounts of bleeding, bleeding that doesn’t stop, dizziness, weakness, black stools, or vomiting blood may signal serious bleeding and need urgent care. ^[2] If bleeding after sex is new, recurrent, or heavy, especially on aspirin, it’s safer to get evaluated. ^[2]

Bottom line

Aspirin’s platelet‑blocking effect can make bleeding from minor sexual tissue trauma more noticeable and prolonged, particularly if you have other risk factors or take interacting drugs. ^[1] Not everyone will experience bleeding during sex on aspirin, but being aware of the risk, using lubrication, avoiding interacting medicines, and seeking care for unexpected or heavy bleeding are sensible steps. ^{[5] [2]}