Post-coital bleeding

Abstract

Post-coital bleeding is a frequent presentation in primary care, and one that causes concern to women, their sexual partners and health care professionals. Causes include trauma to a cervical ectropion, or cervicitis secondary to chlamydial infection, however, cervical cancer can present with post-coital bleeding. There are no national guidelines for the management of post-coital bleeding, however, cervical examination is essential to exclude serious cervical pathology and may require fast track colposcopy referral before considering other investigations and treatment. This article provides a framework for history taking, examination, initial investigations and recommendations for colposcopy referral.