Please help: blood in drained peritoneal dialysis fluid after sex

Hi, Im new to this website but had to join to see if I could get answers or find others in my position. I’ve been on Peritoneal Dialysis for two years now. 10 hours overnight and 2litre extraneal during the day everything dialysis-wise has been going fine and I recently started a new relationship in February this year. I’m writing because something has now started to happen: everytime me and my B/F are intimate (have sex) the next time I drain out my extraneal its always bloody. I have asked my neurologist and my PD nurses nobody can give me an answer and they don’t seem to have experienced this in other patients.

I’m so worried and scared that Ive even stopped my B/F from touching and kissing me as of course it could lead to us being intimate and the sight of the bright red fluid terrifies me. If anyone has experienced this I would love to hear from you or if you have any advice as to what I should do please let me know.


Hi Jessy,
I’m sorry that your PD nurse and doctor have not been more helpful. If I understand correctly, you were not in a relationship during the rest of your time on PD, so this is new to you. Yes? Do you tend to get blood in your bag when you have your period or ovulate? Is it possible that your catheter may have gotten tugged? It takes only a tiny bit of blood to color an entire PD bag red, which does look scary. Do you possibly have endometriosis? Are you well-enough lubricated that you don’t get sore (which might mean tiny tears that could bleed)? I have seen in Facebook groups that others on PD have also reported blood in their bags (this is called hemoperitonum after sex, so you are not alone. I will keep looking into this and ask some PD experts. But, meanwhile, this is probably a matter of a few drops coloring a bag,

This happens to me every month, been doing pd for 18mnths… it started after a new relationship and continued ever since…
Currently waiting to see gynecology thro my home dialysis team referral.
I also suffer from endometriosis, this is what they think the blood is
Hope this helps. Dont panic, just speak to your team…

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Sarah, thank you so much for weighing in on this topic. Endometriosis makes perfect sense–and tends to be underdiagnosed. Jessy, have you been able to get any more information from your care team?

Thank you for all your comments. No I have not been able to get any new information on the situation. I managed to speak to my nephrologist last week and he said he will speak to a gynaecologist to call me. so its all about waiting. Right now researching endometriosis and hemoperitonum to understand it more, I will be back with any updates. Thanks again everyone for your help, its really helped to calm me down.

A GYN exam is a good idea. I did a literature search, and hemoperitoneum is much more common in women than men because of the GYN possibilities. There can be a number of causes, including a period, ovulation, endometriosis, a ruptured ectopic pregnancy, minor catheter trauma. It is almost always a benign problem that does not affect the success or length of PD. Do you have polycystic kidney disease? If so, a ruptured cyst can cause hemoperitoneum.

My best guess is that intimacy bumps your catheter a bit (do you use a belt to keep it out of the way?).