Intermenstrual and postcoital bleeding

Abstract 

Abnormal or unscheduled bleeding from the lower genital tract is common. In some women, bleeding can be the first symptom of vulval, vaginal, cervical or endometrial cancer. The majority of women, however, will have a benign or idiopathic cause. The investigation of abnormal bleeding will vary and is dependent on a number of factors, including age, co-existing medical conditions and cervical smear history. Based on these variables, a gynaecologist will be able to make an assessment of risk of malignancy. The majority of women will have a low risk of underlying malignancy and not need any further investigation. Treatment of abnormal genital tract bleeding will depend on the cause. This may involve removal of an abnormality or hormonal treatment to regulate or suppress bleeding. In many women, no cause for abnormal bleeding will be found.

Keywords: cervical cancer, cervical smear, colposcopy, endometrial biopsy, endometrial cancer, hysteroscopy