RANZCOG - IMB and PCB guideline

Question 1

For women with a history of intermenstrual bleeding (reproductive age group) what should your investigation/management steps be?

Answer 1

• Take sexual health hx
• if at risk of STI then takes swabs and treat accordingly
• perform cervical smear - HPV and LBC (liquid based cytology)
• if they re-present or there is recurrence then USS + refer to GOPC

Question 2

For women with post coital bleeding (reproductive age group) what are your management steps?

Answer 2

• hx - sexual health
• swabs for STI
• HPV + LBC
• if recurrence refer with USS to GOPC

Question 3

How would you counsel a women with either IMB or PCB if presents concerned about cancer?

Answer 3

• genital tract malignancy is an uncommon cause of abnormal bleeding at any age
• genital tract malignancy is particularly rare in young women (if patient is young)
• infection is the commonest cause of abnormal bleeding
• however worth checking if recurrence for malignancy