Whenever woman in the reproductive age group, that is between 15 years to 45 years, has bleeding other than at a time when she is expecting menses, first and foremost is to rule out pregnancy and pregnancy related complications. It could be a sign of early miscarriage where she has missed her pregnancy in totality or it is a complication of pregnancy like ectopic pregnancy or tubal pregnancy. In some cases the intermenstrual bleeding in between her periods could be stress related. It could be hormone tablet related like she is on contraceptive pills. In the 40 plus age it could be a sign of cervical erosion. And infection or a cervical polyp, in the latter premenopausal age group it could be a sign of early cancer carcinoma of the cervix and hence she would need a regular checkup including a pap smear and a biopsy including an ultrasound examination. At times an ovarian cyst or a polycystic ovarian disease can also cause irregular spotting often or in between her expected menses.

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