Abnormal vaginal bleeding is any bleeding outside your normal period: spotting between periods, bleeding after sex, bleeding in pregnancy or any bleeding after menopause. Common causes include hormonal changes, contraception, polyps, fibroids, infection and cervical changes. Postmenopausal bleeding and bleeding in pregnancy always need prompt assessment; most other causes are benign and treatable.
- Common causes
- Hormones, polyps, infection, contraception
- Always check
- After menopause, in pregnancy
- First tests
- Pregnancy test, ultrasound
- Also
- Pap/HPV test, swabs
- Timing
- Ultrasound often same day
- Cost guide
- Consult ₩50,000–100,000
What counts as abnormal vaginal bleeding?
This page focuses on bleeding outside your regular period. If your periods themselves are heavy, see heavy menstrual bleeding; for an overview of all cycle problems, see menstrual disorders.
- Intermenstrual bleeding — spotting or bleeding between periods
- Postcoital bleeding — bleeding after intercourse
- Postmenopausal bleeding — any bleeding 12 months or more after your last period
- Breakthrough bleeding — spotting on hormonal contraception
- Bleeding in pregnancy — including early pregnancy
Common causes by pattern
| Pattern | Common causes | Less common but important |
|---|---|---|
| Between periods | Ovulation spotting, contraception, polyps, fibroids | Endometrial hyperplasia, infection |
| After sex | Cervical ectropion, cervicitis (e.g., chlamydia), cervical polyp | Cervical precancer or cancer |
| After menopause | Vaginal atrophy, endometrial polyp, hormone therapy | Endometrial hyperplasia or cancer |
| On contraception | Breakthrough bleeding in the first months | Missed pills, infection, pregnancy |
| In pregnancy | Implantation bleeding, cervical changes | Miscarriage, ectopic pregnancy |
How the cause is found
- Consultation in English When the bleeding happens, how much, your contraception, sexual health and menopause status.
- Pregnancy test Done first for anyone who could be pregnant.
- Examination A speculum exam looks at the vagina and cervix; a Pap smear or HPV test if due, and swabs for infection.
- Transvaginal ultrasound Same-day pelvic ultrasound measures lining thickness and looks for polyps and fibroids.
- Further tests Endometrial biopsy or hysteroscopy when the lining is thick or bleeding persists, especially after menopause.
A thickened lining or a polyp can cause spotting between periods or bleeding after menopause.
After the polyp is removed or the lining is treated, the cavity is smooth and bleeding often settles.
Treatment depends on the cause
- Infection — antibiotics and partner treatment where relevant; see STD testing.
- Polyps — removal, usually as a short procedure; see polypectomy.
- Hormonal causes — adjusting contraception or short hormonal treatment to stabilize the lining.
- Vaginal atrophy — vaginal moisturizers or low-dose vaginal estrogen after assessment.
- Cervical changes — follow-up with colposcopy and treatment if needed.
At Yoonho Women’s Hospital in Apgujeong, Seoul, the cause and options are explained in English before any treatment, with written instructions to take home.
When is vaginal bleeding an emergency?
Bleeding after menopause is not usually an emergency, but it should be checked within days to weeks rather than waited on. In Korea, call 119 for an ambulance.
Cost and insurance
As a general guide, a consultation is about ₩50,000–100,000, with ultrasound, Pap/HPV tests or swabs added as needed; a written estimate is given after consultation. Read about health insurance for foreigners, or request English documents for travel insurance claims.
Why international patients choose Yoonho
Frequently asked questions
Is spotting between periods normal?
Light spotting around ovulation or in the first months of a new contraceptive can be normal. Spotting that keeps happening, or bleeding after sex, should be checked.
Is bleeding after menopause serious?
It is often caused by benign conditions such as atrophy or polyps, but it can be the first sign of endometrial cancer, so it should always be evaluated.
Can I see a doctor while I am bleeding?
Yes. Bleeding does not prevent an exam or ultrasound, and seeing it can help the diagnosis.
Could bleeding after sex be an STI?
Yes. Chlamydia and other infections can inflame the cervix and cause bleeding after intercourse. Testing is quick and treatment is usually simple.
Can I be checked quickly as a visitor to Seoul?
Walk-ins are welcome during clinic hours, and ultrasound is often done the same day with results explained in English.
OB-GYN Specialist · Director of OB-GYN
M.D., Ewha Womans University College of Medicine · Former Clinical Instructor, Ewha Womans University Mokdong Hospital · Member, Korean Society of Menopause
Last reviewed: . This page is for general information and does not replace an in-person consultation.
Talk to an English-speaking gynecologist
Yoonho Hospital · 304 Apgujeong-ro, Gangnam-gu, Seoul · Mon–Fri 9:00–18:00, Sat 9:00–13:00 · Walk-ins welcome.