Postcoital Bleeding

Chapter 40 Postcoital Bleeding



INTRODUCTION



Description: Postcoital bleeding is vaginal bleeding that occurs following sexual intercourse.

Prevalence: Common.

Predominant Age: Reproductive age and beyond.

Genetics: No genetic pattern.


ETIOLOGY AND PATHOGENESIS



Causes: Uterine (pregnancy, endometrial polyps, endometrial hyperplasia, endometrial carcinoma, leiomyomata), cervical (polyps, cervicitis, cervical erosion, cervical dysplasia or neoplasia), vaginal (trauma, infection, atrophy), perineal (vulvar lesions, hemorrhoids).

Risk Factors: Hypoestrogenic states (menopause without estrogen replacement, vigorous intercourse, and nonconsensual intercourse [rape]).


CLINICAL CHARACTERISTICS



Signs and Symptoms



• Painless vaginal bleeding related to (after) intercourse


DIAGNOSTIC APPROACH



Differential Diagnosis



• Pregnancy (normal or abnormal)

• Cervical polyps

• Endometrial polyps

• Uterine leiomyomata

• Cervicitis or cervical lesions (including cancer)

• Endometrial cancer

• Endometriosis

• Vaginitis (including atrophic vaginitis)

• Coagulopathy (acquired or iatrogenic)

• Nongynecologic sources of bleeding (e.g., perineal or rectal)

Related posts:

  1. Anemia
  2. Urinary Incontinence: Bypass, Overflow
  3. Acne Inversa (Hidradenitis Suppurativa)
  4. Breast: Intraductal Papilloma

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Jun 6, 2016 | Posted by in GYNECOLOGY | Comments Off on Postcoital Bleeding

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