A menopausal woman, 55 years old, complains of post coital bleeding. What impoant cause of such bleeding should be ruled out?

Vaginal bleeding is the most common symptom occurring in patients with cancer of the cervix. Most often, this is post coital bleeding, but it may occur as irregular or postmenopausal bleeding. Patients with advanced disease may present with a malodorous vaginal discharge, weight loss, or obstructive uropathy. Since the patient is 55yrs of age, malignancy must be ruled out Cervical cancer is more likely to present as post coital bleeding than endometrial malignancy. Adenomyosis is a pre-menopausal presentation mostly