Sex and Aspirin: Safety and Smart Precautions

Sex is generally safe while taking aspirin for most people, but aspirin makes platelets less sticky, which can increase bleeding and bruising. ^[1] Aspirin can also worsen stomach or ulcer bleeding, especially if combined with other blood thinners or NSAIDs. ^{[1] [2]} Knowing your personal risk and a few simple precautions can help you stay safe. ^[3]

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How Aspirin Affects Bleeding

• Aspirin (an NSAID) can increase the chance of bleeding, including from the stomach and other sites, especially if you are over 60, have a history of ulcers or bleeding, drink alcohol heavily, or take other NSAIDs or anticoagulants. ^{[2] [4]}
• Watch for signs of unusual bleeding: blood in urine or stool, nosebleeds, heavy bleeding from cuts, black tarry stools, coughing up blood, vomit that looks like coffee grounds, or unusually heavy menstrual or unexpected vaginal bleeding. ^[5]
• If you need procedures (including dental work), you may need special steps to prevent excessive bleeding; do not stop daily aspirin without discussing it with your clinician. ^[6]

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Is Sexual Activity Safe?

For most people on aspirin, sex is safe because sexual activity itself doesn’t typically trigger dangerous bleeding. The main consideration is your overall bleeding risk and any conditions that could bleed with friction or minor trauma. ^{[2] [4]} If you currently have active bleeding (e.g., gastrointestinal bleeding or nosebleeds) or a diagnosed bleeding disorder, you should be more cautious and seek medical advice. ^[3]

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Practical Precautions During Sex

• Use adequate lubrication to reduce friction-related skin or mucosal trauma and minimize minor bleeding. This is particularly helpful if you’re prone to dryness or irritation. ^[7]
• Avoid rough sexual practices (including strong thrusting or anal sex) if you bruise or bleed easily, or if your clinician has noted low platelets or high bleeding risk. ^[7]
• Limit alcohol around sexual activity, because frequent heavy alcohol use increases aspirin-related stomach bleeding. ^{[2] [4]}
• Avoid stacking NSAIDs (like ibuprofen or naproxen) with aspirin unless your clinician approves, since this raises bleeding risk. ^{[2] [4]}
• If you notice unexpected genital or rectal bleeding after sex, seek medical advice, especially if it’s heavy or recurring. ^[5]

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Erectile Dysfunction Medicines with Aspirin

Common ED medicines (PDE5 inhibitors) like tadalafil (Cialis) and vardenafil (Levitra) do not meaningfully prolong bleeding time on their own, and do not show additive bleeding effects when taken with aspirin. They are generally considered compatible with aspirin from a bleeding perspective. ^{[8] [9]}

• If you have active peptic ulcers or a known bleeding disorder, ED treatment should be used with extra caution and after a benefit–risk discussion. ^[9]
• Continue to avoid nitrates with PDE5 inhibitors for blood pressure safety, separate from bleeding considerations. (General guidance; not an aspirin-specific issue.)

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Special Situations

• Pregnancy: Low-dose aspirin can be recommended in some pregnancies, but higher doses are typically avoided later in pregnancy; discuss any sexual activity questions alongside medication safety with your obstetric clinician. ^{[10] [11]}
• Breastfeeding: There isn’t enough data to fully define infant risk with standard aspirin; decisions weigh benefits and risks. ^[12]

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When to Call Your Clinician

• You develop any signs of unusual or heavy bleeding, black stools, vomiting blood or “coffee grounds,” or ongoing nosebleeds. ^[5]
• You have stomach pain, known ulcers, or a history of GI bleeding and are noticing new symptoms after starting or increasing aspirin. ^[3]
• You’re planning a procedure and wonder whether to pause aspirin; do not stop aspirin without medical advice. ^[6]

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Bottom Line

• Most people can have sex safely while taking aspirin. The key is managing bleeding risk by avoiding additional NSAIDs, limiting alcohol, using lubrication, and watching for warning signs. ^{[2] [4] [7]}
• ED medicines like tadalafil or vardenafil generally do not add to aspirin’s bleeding risk, but use caution if you have ulcers or bleeding disorders. ^{[8] [9]}
• If you have any bleeding symptoms or high-risk conditions, a brief check-in with your clinician is wise before resuming sexual activity. ^{[3] [6]}