The below are examples of gynaecological red flags. Other red flags can exist, and clinical acumen is required. If red flags are present, consider urgent referral.
For more information on gynaecological symptoms and red flags, see NICE CKS guidance.
Endometrial cancer
Post menopausal bleeding (vaginal bleeding >12 months since last menstrual period)
Bleeding after a spell of amenorrhoea
Bleeding that does not settle after using continuous combined HRT for 6 months
Persistent intermenstrual bleeding
Abnormal endometrial thickness or appearance on ultrasound scan
Cervical cancer
Post coital bleeding with no obvious cause such as infection
Persistent intermenstrual bleeding
Abnormal appearance of the cervix
Ovarian cancer
Appetite loss, early satiety, abdominal distension
Persistent urinary urgency or frequency in women >50 years
New IBS symptoms in women >50 years or unexplained change in bowel habit
Fatigue and weight loss
Ascites or pelvic mass that is not obviously fibroids
Elevated CA125 or abnormal appearance of ovary on scan
