An important message regarding the current COVID-19 pandemic. Click here to read more.


Bleeding 2

Step 1: View clinicals

A 27 year old nulliparous woman presents following three episodes of postcoital bleeding over one month. There was no pelvic pain, dyspareunia, vaginal discharge or dysuria. Her menstrual cycles are regular, occurring every 30 days, while her medical history is unremarkable. She has been with her current partner for two years. She had undergone a routine pelvic examination and a pap smear 3 months ago, both of which were normal.

Step 2: Order all relevant investigations

Cervical Biopsy

The cervical biopsy shows diffuse inflammation. There is no evidence of neoplastic transformation.


C. Trachomatis: positive N. Gonorrhoeae: negative

Transvaginal Ultrasound

The ultrasound scan shows no abnormalities.

Microscopy of Discharge

Microscopy of the cervical discharge shows marked leukorrhea. No atypical cells are noted.

Step 3: Select appropriate management

Oral Azithromycin
Pelvic Radiotherapy
Abstinence for 1 Month
Cervical Ablation

Score: ★★☆