A 48-years-old woman presents with intermenstrual bleeding for 2 months. Episodes of bleeding occur anytime in the cycle. This is usually fresh red blood and much lighter than a normal period. It can last for 1-6 days. There is no associated pain. She has no hot flushes or night sweats. She is sexually active and has not notice vaginal dryness. She has three children and has used the progesterone only pill for conception for 5 years.
Her last smear test was 2 years ago and all smears have been normal. She takes no medication and has no other relevant medical history. Examination The abdomen is unremarkable. Speculum examination shows a slightly atrophic-looking vagina and cervix but there are no apparent cervical lesions and there is no current bleeding. On bimanual examination, the uterus is non-tender and of normal size, axial and mobile. There are no adnexal masses. Image 1:…
