Intermenstrual or Postcoital Bleeding

CLINICAL DIAGNOSTIC MANUAL

Intermenstrual or postcoital bleeding refers to vaginal bleeding that occurs outside of the regular menstrual cycle or after sexual intercourse. This type of bleeding can be a sign of various pathologies, some of which may be benign, such as polyps, or more serious, such as endometrial or cervical carcinomas. A thorough evaluation is essential to determine the underlying cause and apply the appropriate treatment.

Condition	Symptoms and Clinical Signs	Suspected Diagnosis	Confirmatory Diagnosis
Endometrial Carcinoma of the Uterus	Abnormal vaginal bleeding, menorrhagia, pelvic pain	History of intermenstrual bleeding, especially in postmenopausal women	Endometrial biopsy, transvaginal ultrasound
Cervical Carcinoma	Postcoital bleeding, abnormal vaginal discharge, pelvic pain	History of postcoital bleeding and abnormal vaginal discharge	Abnormal Pap smear, colposcopy with targeted biopsy
Cervical or Intrauterine Polyps	Intermenstrual bleeding, postcoital bleeding, vaginal discharge	History of abnormal vaginal bleeding	Pelvic examination, transvaginal ultrasound, hysteroscopy
Genital Tract Infections	Postcoital bleeding, vaginal discharge, dysuria, pelvic pain	History of infection symptoms, physical examination revealing inflammation	Vaginal secretion culture, STD tests
Cervical Ectropion	Postcoital bleeding, mucous vaginal discharge	Physical examination revealing cervical ectropion	Colposcopy
Vaginal Atrophy	Postcoital bleeding, vaginal dryness, dyspareunia	History of postmenopausal symptoms, physical examination revealing thinning of the vaginal mucosa	Clinical diagnosis based on physical examination, hormonal level tests if necessary