Losing blood from the vagina following sexual intercourse can occasionally be a symptom of a cancer of the cervix (cancer of the neck of the womb). There are many other reasons for bleeding after intercourse but it is important to make sure that the problem is not due to a cervical cancer, especially as, if it is detected at an early stage, cancer of the cervix is very curable.

If you have noticed bleeding after intercourse it is important not to ignore it or hope it will go away on its own - you should see your family doctor (GP) for a check up.

The Department of Health has recently produced guidelines for GPs about women who come to them because they have bleeding after intercourse. The guidelines say that women over 35 who have noticed bleeding after sexual intercourse for more than 4 weeks should have an urgent appointment with a hospital specialist (a consultant gynaecologist). For women under 35 who experience bleeding regularly after intercourse the GP should still arrange an appointment with the gynaecologist but this does not have to be so urgent.

Normally the urgent hospital appointment means that the specialist will see you within two weeks. For the less urgent appointment you should still see the specialist within four to six weeks.

When the gynaecologist sees you they will take your full medical history and carry out a careful physical examination. The specialist will probably do other tests which may include:

• looking directly at your cervix and vagina using a device called a speculum, which gently separates the walls of your vagina and holds them apart
• colposcopy, where the doctor again uses a speculum but then looks at the cervix through a small microscope to carefully examine its surface and take tiny samples (biopsies) of any abnormal looking areas
• a scan of the pelvis, either a CT-scan or an MRI scan.
  If these tests show that there is a cancer on the cervix then further treatment might involve an operation or it may mean some radiotherapy or chemotherapy, depending on the exact type of the cancer and its size.

Cancers of the cervix are very curable, especially if they are caught early, so if you have noticed bleeding from your vagina after intercourse for more than a week or two it is very important to see your doctor as soon as possible.