Stable patients

Table 3 – Factors to consider

Vaginal bleeding

Duration of bleeding

How often it occurs

Amount of blood (number of pads/tampons), presence of clots

Precipitating factors (specifically ask about toileting, sex and trauma)
Associated symptoms

Infective symptoms including vaginal discharge, itching and pelvic pain

Bowel and bladder symptoms

Symptoms suggesting symptomatic anaemia including fatigue, dyspnoea
Gynaecological History

Age of menarche

Date of last menstrual period

Any breakthrough bleeding since

Are they using HRT

Gravidity and parity, use of the oral contraceptive pill

History of gynaecological procedures or surgeries

Smear test and results

PMH of gynaecological, breast of haematological malignancies


Any medications

History of diabetes mellitus, obesity, hypertension

Screen for malignancy associated symptoms e.g. weight loss

Is there a family history of breast, colon, and endometrial cancer