- Risk factors – ask about partners (number of partners, protection, Hx of sexually transmitted infection etc)
- Ask about other symptoms –discharge, pain
Cervical / endometrial polyps
- May be palpable on bimanual
- Likely visible on speculum
- Could ask patient if she has felt anything unusual
- On examination – smooth red/purple growths that arise from the os. Usually painless, and can be easily removed.
- Likely to be older
- Likely to be an older patient, but may be as young as mid/late twenties
- Ask about smears
- May cause bloody discharge
- On examination – often a firm lump that will exhibit contact bleeding
Trauma / ectropion
- Where is the bleeding coming from? – might seem a silly question, but sometimes it may be coming from the rectum or the urinary system. Any doubt can be solved by using a tampon at the time of bleeding to asses to location.
- Periods – normal? Heavy? Absent? Any change recently?
- Contraception – what is she using?