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

  • postcoital 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


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