Managing women with post-coital bleeding: a prospective observational non-comparative study

The management of post-coital bleeding (PCB) is inconsistent in the UK and there are no guidelines to ensure good practice. This prospective study was conducted to review the management and identify the diagnostic outcome of 137 women treated according to a locally devised protocol based on the best available evidence. Women underwent smear testing, taking triple swabs and colposcopy. The endometrium was investigated in postmenopausal women and in those aged >35 years with associated intermenstrual bleeding. Of those who had PCB for >4 weeks, only 8/124 (6.5%) were referred urgently. Twenty eight (20.4%) women were found to have significant pathology; 14 (50%) were <35 years of age, 26 (92.8%) had PCB for >4 weeks, whereas seven (25 %) suffered severe episodes, suggesting that the duration, but not age or severity, is relevant. A large multi-centre study is needed to provide more information in order to optimise the management.