Non-menstrual bleeding

Non-cyclical, patternless vaginal bleeding is often described as metrorrhagia. A useful classification is as: (1)

• post-coital bleeding
• intermenstrual bleeding
• postmenopausal bleeding

The implication is that of a local lesion and the possibility of malignancy must be always be considered. However, non-focal causes are common, for example:

• abortion - especially in a young woman
• dysfunctional uterine bleeding
• break-through bleeding due to the progestogen only pill

Assessment may be approached through:

• history
• systematic examination
• diagnostic curettage
• biopsy of any visible lesion

Reference

1. Sweet M.G. et al. Am Fam Physician 2012. Evaluation and management of abnormal uterine bleeding in premenopausal women. Available from: https://pubmed.ncbi.nlm.nih.gov/22230306/