Sporadic abnormal vaginal bleeding (intermenstrual, postcoital and postmenopausal bleeding)

Sporadic abnormal vaginal bleeding is a common symptom in both pre- and postmenopausal women. Assessment aims to exclude sinister underlying pathology. Modern management should be based on one-stop gynaecological assessment and is reviewed in this article. This has been driven by the demands of both patients and clinicians to provide a rapid, accurate diagnosis, with the minimum of investigations and invasive procedures. The need to avoid the unnecessary costs of multiple outpatient visits and inpatient admissions is also a major factor in this development.