I am 42 year old mother. Routine history of annual negative Pap smears for 23+ years. Vigilant about smears. No STDs. History of cervical erosion and bleeding throughout pregnancy . No treatment given . colposcopys performed with negative results. Not taking any OCPs. no contraception used. PCOS diagnosis 20 years ago. Continue to have heay post coital bleeding every time. Due for Pap smear again. Is there any other test I should be having to assess PCB ? Heaviness bothers me. Starts bright red. Following day bleed is brown. Please help.
The cervix is the part of the uterus in direct contact with the vagina. Cervix morphology changes throughout a woman’s life, and these modifications are hormone related. In addition to those changes, several factors, such as STDs, HPV infection, tobacco, and OCPs, explain the development of cervical diseases that may cause post coital bleeding. These are usually diagnosed with Pap smears or biopsies. However, women may bleed after intercourse due to “cervical erosion” (also known as cervical ectropion) that occurs as a consequence of the hormonal status. So, post coital bleeding may occur when no serious cervical disease underlies. I think this should be your case – with regular Pap smears and negative colposcopies it’s unlikely that you have a cervical disease. You say that it starts bright red becoming brown the following day – this is explained by the decreasing amount of blood you loose after intercourse. You don’t take OCPs, which is helpful for this particular issue. But now, what to do? First line treatment consists in vaginal preparations; in Europe, Nelex is an available solution – it eliminates damaged tissues and has haemostatic properties (meaning it can stop the bleeding). Although you should start with this type of treatment, it is possible that it won’t work considering the heaviness of your bleeding. Otherwise, there are destructive treatments available such as cryocoagulation / LASER vaporization of the cervix.