A 19-year-old woman presented because of the recent onset of breakthrough bleeding. She has been taking the same oral contraceptive Pill for two years, she has not forgotten any pills or had diarrhea or vomiting. She has been with her current sexual partner for four months and has recently stopped using condoms as additional protection. She is otherwise well. On examination the vulva and vagina are healthy and there is no inflammation. There is a small cervical ectropion and profuse mucus and pus discharge from the cervix. There is no tenderness on bimanual vaginal examination and no masses palpable. An endocervical swab and urine test was administered.

A 19-year-old woman presented because of the recent onset of breakthrough bleeding. She has been taking the same oral contraceptive Pill for two years, she has not forgotten any pills or had diarrhea or vomiting. She has been with her current sexual partner for four months and has recently stopped using condoms as additional protection. She is otherwise well. On examination the vulva and vagina are healthy and there is no inflammation. There is a small cervical ectropion and profuse mucus and pus discharge from the cervix. There is no tenderness on bimanual vaginal examination and no masses palpable. An endocervical swab and urine test was administered.