What is the most likely diagnosis for a 24-year-old woman experiencing increased clear vaginal discharge and post coital spotting after restarting the pill?

The scenario describes a 24-year-old woman who has started experiencing increased clear vaginal discharge and post coital spotting after restarting the contraceptive pill. The most likely diagnosis in this context is cervical ectropion.

Cervical ectropion occurs when the columnar epithelial cells, which normally line the inside of the cervical canal, extend onto the surface of the cervix. This condition can be influenced by hormonal changes, such as those induced by oral contraceptives, leading to increased vaginal discharge and the potential for post coital spotting due to the fragility of the newly exposed tissue.

Increased discharge is a common symptom associated with cervical ectropion, and spotting after intercourse can occur as the area can be sensitive and easily injured. The clear nature of the discharge further aligns with this diagnosis since ectropion typically causes a mucoid discharge, which is often clear.

Vaginal infections, endometrial polyps, and pelvic inflammatory disease could also present with varying symptoms of vaginal discharge and spotting, but they tend to have additional signs or symptoms that are not mentioned in the question, making cervical ectropion the most appropriate diagnosis based on the information provided.