Post-coital bleeding

​​​​​​​Emergency

If any of the following are suspected, seek emergency medical advice or refer the patient to the emergency department (via ambulance if necessary)

  • Acute trauma including vulva or vaginal lacerations, haematoma and/or penetrating injuries
  • Inevitable and/or incomplete miscarriage or termination
  • Uncontrolled vaginal bleeding and haemodynamic instability

When public outpatient services are not routinely provided

  • Histopathologically confirmed genital tract malignancy
    Note: referral to gynaecological oncology is indicated, where available
  • Known genital tract malignancy undergoing treatment
  • Post coital bleeding that ceases following treatment of chlamydia or gonorrhoea infection
  • Single episode of post-coital bleeding with normal cervical screening test and liquid based cytology (LBC) ​

Criteria to access public outpatient services

CategoryCriteria
Category 1
Recommended to be seen within 30 calendar days.
  • Abnormal glandular cells (i.e. adenocarcinoma in-situ; AIS) on cervical screening test
  • Squamous carcinoma of cervix on liquid based cytology (LBC)
  • Suspected genital tract malignancy as indicated by suspicious vulval lesion and/or abnormal appearing cervix with an obvious mass
​Category 2
Recommended to be seen within 90 calendar days.
​
  • Post-coital bleeding in women who have had a hysterectomy for cervical dysplasia and genital tract malignancy
  • Regular post-coital bleeding that persists > 3 months with negative human papillomavirus (HPV) or liquid based cytology (LBC) ​

Category 3
Recommended to be seen within 365 calendar days.

  • Irregular, unexplained post-coital bleeding for > 3 months with normal cervical screening test and
    normal pelvic ultrasound (transvaginal preferred)
  • Post-coital bleeding in women who have had a hysterectomy for benign conditions​

Information to include within a referral

Required

  • Reason for referral
  • Details of the presenting condition, including symptoms and their duration
  • Provisional diagnosis
  • Patient health summary (such as relevant medical history, relevant investigations, current medications and dosages, immunisations, allergies and/or adverse reactions), including specifically:
    • Pattern of post-coital bleeding
    • Findings of speculum examination
    • Co-test result
    • High vaginal swab (HVS) result (unless examination is not possible)
    • Sexual health history
    • Sexually transmitted infection (STI) screen result
    • Menstrual history (cycle, day/months, days of bleeding, blood loss, previously trialled treatments)
    • Abdominal examination findings
    • Pelvic examination (preferred)
    • Trans-vaginal or pelvic ultrasound
    • Beta-human chorionic gonadotropin (ßhCG)

If available

  • Full blood count
  • Contraceptive use
  • Height, weight and body mass index ​

Important information for referring health professionals

If there is a change to a patient’s condition while waiting for their appointment, referring health professionals may further investigate and manage the situation, or send an updated referral to the outpatient service. Where there are significant concerns about a patient's condition, referring health professionals may check HealthPathways for urgent/same day advice or contact the relevant clinical team.​​

Current as at: Monday 23 March 2026
Contact page owner: System Purchasing