Differential Diagnosis for Vaginal Bleeding Post Coital
Single Most Likely Diagnosis
- Cervical Ectropion or Cervicitis: This is often the most common cause of post-coital bleeding due to the mechanical trauma or friction during intercourse that can cause bleeding from the cervix, especially if there is an ectropion (a condition where the glandular cells lining the inside of the cervix are everted to the outside) or an inflamed cervix.
Other Likely Diagnoses
- Vaginal Dryness or Atrophy: Insufficient lubrication during intercourse can lead to vaginal dryness and potential tears or irritation, which may cause bleeding.
- Uterine Fibroids: These benign growths in the uterus can sometimes cause bleeding, especially if they are submucosal or if they outgrow their blood supply.
- Endometrial Polyps: These growths in the lining of the uterus can cause irregular menstrual bleeding and may also bleed with intercourse.
- Cervical Polyps: Similar to endometrial polyps, these can cause bleeding, especially 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, as early detection significantly improves prognosis.
- Endometrial Cancer: Similar to cervical cancer, endometrial cancer can present with postmenopausal bleeding or irregular bleeding in premenopausal women, including post-coital bleeding.
- Pelvic Inflammatory Disease (PID): An infection of the female reproductive organs that can cause bleeding, among other symptoms.
Rare Diagnoses
- Vaginal Cancer: A rare type of cancer that can cause bleeding, including post-coital bleeding.
- Trauma: Physical trauma to the genital area can cause bleeding.
- Blood Clotting Disorders: Rare conditions that affect blood clotting can lead to excessive or prolonged bleeding, including after intercourse.
- Arteriovenous Malformations: Abnormal connections between arteries and veins that can cause bleeding, including in the genital area.