Differential Diagnosis for Bleeding after Intercourse
Single Most Likely Diagnosis
- Cervicitis: This is often the most common cause of bleeding after intercourse, particularly if the bleeding is minimal and associated with other symptoms like abnormal vaginal discharge. Cervicitis can be caused by infections such as chlamydia or gonorrhea.
Other Likely Diagnoses
- Vaginal Dryness or Atrophy: Especially in postmenopausal women, lack of estrogen can lead to thinning and drying of the vaginal walls, making them more susceptible to bleeding during intercourse.
- Cervical Polyps: These are growths on the cervix that can cause bleeding, especially after intercourse or during menstruation.
- Endometrial Hyperplasia: A condition where the lining of the uterus grows too thick, which can lead to irregular menstrual bleeding and bleeding after intercourse.
Do Not Miss Diagnoses
- Cervical Cancer: Although less common, it is crucial to rule out cervical cancer as a cause of post-coital bleeding, especially in women who are overdue for a Pap smear or have a history of abnormal Pap results.
- Endometrial Cancer: Similar to cervical cancer, endometrial cancer can cause irregular vaginal bleeding, including bleeding after intercourse, and must be considered in the differential diagnosis.
Rare Diagnoses
- Vaginal Cancer: A rare type of cancer that can cause bleeding, including after intercourse.
- Uterine Sarcoma: A rare malignant tumor of the uterus that can cause abnormal vaginal bleeding.
- Blood Clotting Disorders: Certain conditions that affect blood clotting can lead to easy bruising and bleeding, including after intercourse, though this would be an uncommon primary presentation.