Case-based learning| Volume 25, ISSUE 4, P106-112, April 2015

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Intermenstrual and postcoital bleeding

Published:February 16, 2015DOI:


      Unexpected vaginal bleeding, whilst responsible for much anxiety amongst women, is rarely associated with any serious underlying pathology. Nevertheless, bleeding which occurs spontaneously in between menses or after intercourse is recognised as a ‘red flag’ symptom for gynaecological cancer. Infection, hormonal fluctuations, benign cervical and endometrial conditions are, however, more common causes of abnormal bleeding. The role of the generalist clinician is to diagnose and treat uncomplicated conditions, whilst also determining the likelihood of malignancy and referring for further investigations appropriately.


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      Further reading

      1. British Association for Sexual Health and HIV Clinical Effectiveness Group guidelines. 2006–2014
      2. Management of Unscheduled Bleeding in Women Using Hormonal Contraception. 2009 (Faculty of Sexual and Reproductive Healthcare)
      3. NHSCSP No 20: Colposcopy and Programme Management: Guidelines for the NHS Cervical Screening Programme. 2010
      4. Referral Guidelines for Suspected Cancer. NICE Clinical Guideline 27 (Updated 2011)