Spotting After Sex: Causes, Concerns & When to See a Doctor

Question
Hello,

Over the last few months, not each time, but occasionally when my husband and I had sex I noticed light bleeding/spotting afterward.  I had followed my doctor's suggestions and had a normal pap for 3 years in a row and was then to have another one 3 years later.  I am 34 years old and married for 7 years.

I was slightly overdue for my pap and went to the doctor this week for one (as well as a referral to a fertility specialist as we have been trying to conceive for 15 months).  He did the pap and I asked if he noticed anything that could be causing the spotting.  He didn't sound concerned, but said that my cervix was slightly irritated and that could explain the bleeding, but not the fertility problem.  I asked what could cause the irritation and he said usually nothing.  As part of the fertility workup, he also tested for STDs (which as expected were negative).

I have to wait about 5 weeks for the pap results and did look on the internet for info about inflammation/irritated cervix and now am very concerned.  Although my doctor likely didn't want to concern me until the pap results are back, from everything on the internet it seems to say that the irritation is usually as the result of an STD (which I don't have) or cervical dysplasia/cancer.  Since I've had the bleeding off and on for a few months, the inflammation must have been there for a while so I am quite worried about how serious this is.  (Likely unrelated, I also have spotting 3-4 days before my period starts - I think the fertility specialist will have to look into this although my own doctor says it is normal).

In your experience, is there anything else that is a likely explanation for the irritation, or am i right to think this could likely be related to something more serious (cervical cancer)?  

Thank you very much for your time.

Answer
A reddened, sort of irritated looking cervix that bleeds easy from intercourse is very common.  STD's can cause it, but you've been checked for them.  Most likely your pap smear will be negative.  The redness of the cervix is probably what we call ectopy, which means that the cells that normally line the cervical canal are farther out on the front of the cervix than average.  This is common and no reason for concern.  It can be treated by freezing your cervix, but I would hesitate to do that because you're trying to conceive.  I would ask the fertility specialist his/her opinion.
I suspect that your spotting is more likely related to not ovulating regularly, especially since you also have spotting before your period starts.  I think the spotting after sex and spotting before your period are related, and are probably either from a polyp in the uterus or from not ovulating regularly.  Best wishes.