Post Coital Bleeding

This condition is treated in the Gynaecology clinic.

Emergency Referral Criteria

Criteria for Emergency include: 

• Ectopic pregnancy 
• Ruptured haemorrhagic ovarian cyst 
• Ovarian torsion 
• Acute/severe pelvic pain 
• Significant or uncontrolled vaginal bleeding 
• Severe infection 
• Abscess intra pelvis or PID 
• Bartholin's abscess/acute painful enlargement of a Bartholin's gland/cyst 
• Acute trauma including vulva/vaginal lacerations, haematoma and/or penetrating injuries 
• Post-operative complications within 6 weeks including wound infection, wound breakdown, vaginal bleeding/discharge, retained products of conception post-op, abdominal pain 
• Urinary retention 
• Acute urinary obstruction 
• Any molar pregnancy 
• Inevitable and/or incomplete miscarriage 
• Hyperemesis gravidarum 
• Ascites, secondary to known underlying gynaecological oncology 

If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.

Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.

Statewide Referral Criteria (SRC)

Criteria for referral to public hospital specialist clinic services

? Red flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Urgent (Category 1)

• Suspected malignancy 
• SCC, positive oncogenic Human Papilloma Virus (HPV) and/or HSIL (High-grade Squamous Intraepithelial Lesion) on LBC (Liquid Based Cytology), glandular lesion on cervical screening 

Semi-urgent (Category 2)

• Post-coital bleeding recurs or persists despite negative Human Papilloma Virus (HPV) or Liquid Based Cytology (LBC) 

Routine (Category 3)

• Nil category 3 criteria

Information to be included in the referral

(Referral may be returned without this)

Essential supporting information

Pathology

• Cervical screening testing
• Sexually transmitted infection screening

Imaging

• Pelvic Ultrasound  
• Transvaginal pelvic USS should be done when indicated.  

Note: If delay obtaining a USS may impact critical care this should be clearly indicated in the referral, however the scan should still be booked. Phone discussion on a case-by-case basis may be needed. 

Investigations/other

• Speculum examination findings

Additional information

• Sexual health history
• Signs, symptoms and duration of bleeding

Interim/GP management

To refer a patient with this condition, please see the Gynaecology clinic page for the full referral process and templates.

Consider use of topical oestrogen for vaginal atrophy.

Consider treatment for Bacterial Vaginosis, if appropriate.
Support and counselling

• Report further episodes
• Encourage return if symptoms recur / change

For more information, please view:

Postcoital Bleeding - HealthPathways Tasmania

Intermenstrual or Post Coital Bleeding - HealthPathways Tasmania

Additional resources

View all clinic availability