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Melanie, a 39 year old woman gravida 3, Para 2, MC 1, presents with a 3 month history of spotting after intercourse. She is taking a combined oral contraceptive pill and has missed 1 pill in the previous cycle which she noticed the following day, so didnt make up the dose.
Her periods have been coming regularly, and her volume of menstrual loss is normal. There is no pain with periods or intercourse.
She decided to attend this time as during sex, she started to bleed and there was a worrying amount of blood evident.
Her partner checked his semen with masturbation and there was no blood present