This means bleeding at any time other than the mentrual cycle. Bleeding from the cervix may indicate a cervical erosion (outward growth of cells that normally lie in the canal of the cervix) or an endocervical polyp (a finger-like growth occuring from the lining of the cervix).

Bleeding from the uterus can indicate an endometrial polyp ( a growth occurring from the uterus lining) or a fibroid ( a benign tumour arising from the muscle of the uterus which can grow to an enormous size). Fibroids are common in childless women and can cause recurrent miscarriage.

Other possible causes include the contraceptive injection, IUD, incorrect use of the contraceptive pill, or as a result of hormone replacement therapy (HRT). If it occurs for longer than 3 months in women of child bearing age, it should be investigated. If it occurs post-menopausally - it should be investigated immediately.

Stress, hormonal factors, anaemia, depression, rapid weight change, excessive exercise and the use of certain medicines can cause an abnormally long or short cycle or a missed period. Tumours of the uterus, ovaries, cervix and thyroid and pituitary glands are also possible causes. Persistent irregularities at any age warrant a full physical examination. Treatment depends on the underlying causes and may involve hormonal therapy or medication for depression or anaemia.