Sporadic vaginal bleeding

Sporadic vaginal bleeding that is not related to the menstrual period is a common but usually innocent symptom. However, it can also be a marker for the more sinister pathologies of endometrial and cervical carcinoma, and consequently, the foremost principle of management is to exclude these carcinomas. The assessment of each case should proceed in a logical manner based on the patients' age, hormonal status and general health. This article presents four case studies of women presenting with sporadic vaginal bleeding and explores the investigation and management of each.