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Post coital bleeding,pelvic examination,ultra sound,dark brown blood stain

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Practicing since : 2001
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i am 45 years old. 3 months ago i had a post coital bleed. I was referred to a consultant who did a pelvic examination and an ultra sound. I was reassured all was ok. I have just had another post coital bleed. Both have occurred on the 8th day of my cycle and have been after late periods. otherwise my periods are still regular. 36 hours after this last time i had a really dark brown blood stain on my pants. now 48+ hours later i have almost clear discharge but with a few brown/black "bits". I am now really scared! I had a normal smear 12 months ago
Posted Mon, 30 Apr 2012 in Vaginal and Uterus Health
Answered by Dr. Rakhi Tayal 15 minutes later

Thanks for writing to us.

Post coital bleeding is most commonly seen due to chronic cervicitis or cervical polyp.

I strongly recommend that you must go for a repeat pap smear testing and if this episode repeats itself, even a cervical biopsy may be needed.

Vaginitis and bacterial infection like chlamydia or gonorrhea may also cause such episodes and can be diagnosed by vaginal swab examination. Antibiotics are needed for treatment.

Other causes that need to be excluded are uterine fibroids, polyps or endometriosis which are not likely in your case as you have already had a clear ultrasound examination.

I hope my answer and recommendations are adequate and helpful. Waiting for your further follow up queries if any.


Above answer was peer-reviewed by
Follow-up: Post coital bleeding,pelvic examination,ultra sound,dark brown blood stain 16 hours later
so why didn't the consultant perform a colcoscopy last time? I am now really worried that something serious has been missed for the last 3 months. He seemed to just accept that my last clear smear a year ago was adequate.
Answered by Dr. Rakhi Tayal 12 minutes later
Hello again,

Thanks for writing back.

Ideally PAP smear should be repeated every year or you can get yourself vaccinated against HPV to reduce the chances of cervical cancer.

Since the episode has happened twice, you do need to have investigations done.

Hope my answer is helpful.

Wishing you a trouble free speedy recovery.

Above answer was peer-reviewed by
Follow-up: Post coital bleeding,pelvic examination,ultra sound,dark brown blood stain 1 hour later
but are you saying then that cervical cancer is the most likely cause? Why didn't the consultant think of this? Why haven't I bled after sex every time and there has been a 3 month gap?
Answered by Dr. Rakhi Tayal 4 hours later
Cervical cancer is not the most likely cause but it has to be kept in mind while thinking of the diagnosis as it is the most serious of the causes and needs to be ruled out first. It is not necessary the diagnosis. The most likely cause is just an unhealthy cervix- inflammation or a hormonal imbalance .
Do not worry and wait for the PAP smear.
Hope this helps.
Above answer was peer-reviewed by
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