What is bloody discharge?

Bloody discharge is your normal vaginal discharge except it contains blood. Bloody discharge is a sign of bleeding from your cervix, vagina or uterus. The most common time to get it is at the start, during, and at the end of your period. It can look red, pink, or brownish in colour. Bloody discharge can sometimes smell like copper.

What does bloody discharge look like?

Bloody discharge is usually bright red if it contains fresh blood from your period. Bloody discharge can also look pink if there is only a little bit of blood in your discharge. It may appear brown-ish if the blood has been in your vagina for a bit longer. 

Is bloody discharge normal?

Discharge can keep your vagina clean and protect it from infections. It is normal to get bloody discharge near your period or in the first 3 months of taking hormonal contraception like the contraceptive pill. If you have other symptoms and bloody discharge out with your period, it may be a sign of pregnancy, an infection, or, more rarely, a gynaecological cancer. 

Common causes of bloody discharge

The most common causes of bloody discharge are:

• periods
• pregnancy
• sex
• menopause
• hormonal contraception
• Infection
• gynaecological cancer

What infections can cause bloody discharge?

Some infections can cause vaginal bleeding and discharge, which causes bloody discharge. STIs are a cause of bloody discharge and can make you bleed after sex or between your period. 

Can bloody discharge be a sign of infection?

Bloody discharge might be a sign of infection if you have other symptoms. Other symptoms to look out for include:

• pelvic cramping
• itchiness in and around your vagina
• unusual discharge, such as yellow discharge or smelly discharge
• pain when peeing
• pain when having sex

The most common infections that can cause bloody discharge are:

• STIs like chlamydia which can cause irregular bleeding after sex and between periods
• vaginal infections, such as thrush, which can irritate the vagina and cause bleeding if you have scratched the skin in your vagina whilst itching 

If you think you have an infection, you should speak to your doctor. 

Can periods cause bloody discharge?

Periods are the main cause of bloody discharge, as your period blood mixes with your natural discharge. You may get bloody discharge at the start, during, and at the end of your period. 

Bloody discharge before period 

Bloody discharge may happen at the start of your period because your vaginal wall is beginning to break down. When this happens, blood can become mixed with your discharge, causing bloody discharge. When your period gets heavier, this will be replaced by period blood. 

Sometimes, bloody discharge before your period is a sign of pregnancy. If you get bloody discharge and do not start your period when you are supposed to, you should take a pregnancy test and contact your doctor if this is positive.

If you get unexpected bloody discharge before or after your period is due or between periods you should contact your doctor to check for any underlying causes.

Bloody discharge after period

As your vagina uses discharge to clean itself, you may get bloody discharge at the end of your period. This can include blood or dead cells that were left in your vagina at the end of your period. This may be normal for you and if so, you can continue to use a sanitary towel to prevent staining in your underwear. 

If you get bloody discharge after your period has ended speak to your doctor. They may suggest further tests to find out why. 

Bloody discharge and pregnancy

Bloody discharge might be a sign that you are pregnant if it happens during the first few weeks of your pregnancy. During the end of your pregnancy, you may get bloody discharge before you go into labour. If you have bloody discharge during your pregnancy, it is best to speak to your doctor or midwife straight away, to check for any serious causes such as an ectopic pregnancy or a miscarriage.

Is bloody discharge a sign of pregnancy?

Bloody discharge is a sign of pregnancy for some women. This is because when a fertilised egg attaches itself to your womb lining it can cause vaginal bleeding, known as spotting.  If you miss your period, take a pregnancy test to make sure. 

Bloody discharge during early pregnancy

Bloody discharge during early pregnancy may be a sign of the egg attaching itself to your womb lining. If you continue to get bloody discharge, this might mean you are bleeding and you should speak to your midwife straight away. They can do tests to check on your baby. 

Bloody stringy discharge during early pregnancy

If you get bloody stringy discharge during early pregnancy, you should speak to your midwife as it could be a cause for concern. Bloody stringy discharge might be a sign of something more serious, such as an ectopic pregnancy or miscarriage. 

If you have other symptoms such as heavy bleeding from your vagina, dizziness,  sharp pains in your stomach or shoulder tip, urinary symptoms or nausea or vomiting, go to A&E or call 999 straight away. 

Bloody discharge during pregnancy

During the second and third trimesters, you might get some bloody discharge. This may be more common after sex or after you have been to a midwife appointment. Bloody discharge in pregnancy is caused by a small amount of blood passing through your vagina with your normal discharge. 

During the end of your third trimester, you may get bloody discharge which can be a sign your body is getting prepared for labour. 

If you are pregnant and have any bloody discharge or vaginal bleeding you should always contact your midwife or doctor urgently for review. 

Is bloody discharge a sign of labour?

Yes, if you are almost at the end of your pregnancy, you may get bloody discharge. This is called a “show”. It often looks like sticky pink mucus and happens before you go into labour. 

Is bloody discharge a sign of miscarriage?

Bloody discharge can be a sign of miscarriage, especially if there is a lot of blood or your discharge contains blood clots. Other signs of a miscarriage include dizziness, passing tissue from your vagina, and severe pains in your stomach and cervix area. If you think you could be having a miscarriage you should contact your midwife or doctor urgently or attend A&E if you feel dizzy or are in severe pain. 

Does discharge change during pregnancy?

Your hormones change during pregnancy, which can cause your discharge to change. You may get more discharge than before. Your discharge can prevent vaginal infections from travelling to your baby in the womb. 

During pregnancy, vaginal discharge can look clear, white, or thin. If your discharge smells unpleasant, is yellow or green, or contains any blood, speak to your midwife or doctor. 

Is bloody discharge during pregnancy a cause for concern?

If your bloody discharge is very red or seems more like a period, this could be a cause for concern. It is hard to tell if bloody discharge is normal or not, so you should always be safe and speak with your midwife or doctor, even if you only notice spotting or light bleeding. 

Bloody discharge and sex

Bloody discharge during or after sex can be caused by irritation to your vagina during sex or other benign conditions like cervical or endometrial (womb) polyps. However, it’s always important to see your doctor if you have any bleeding during or after sex so they can rule out a more serious cause like an STI or, rarely, gynaecological cancer..  

Why do I have bloody discharge after sex?

There are lots of potential causes for bloody discharge after sex. If the skin in your vagina is thinner than usual, such as when you are breastfeeding, sex can cause friction inside your vagina, which may cause light bleeding even if you did not feel anything during sex. It can also be caused by benign conditions like polyps on your cervix or womb or a cervical ectropion (where the lining on the inside of the cervix covers the outside of the cervix too). Even if this only happens once you should contact your doctor so they can rule out any more serious causes. 

Another cause of bloody discharge after sex is an STI such as chlamydia. You might also have other symptoms, such as pain when peeing or unusual discharge. You can get tested through our online service or by visiting a sexual health clinic near you. If you think you might have an STI and have pelvic pain, bleeding during or after sex or between periods or pain on having sex these can be signs of a more serious condition called pelvic inflammatory disease and you should contact your GP or local sexual health clinic for treatment. 

More rarely bloody discharge during or after sex can be caused by cancer of the vagina, cervix or uterus. It’s really important to attend any smear test appointments you are invited to and to contact your GP urgently if you have any bleeding more than 12 months after your last period (post-menopausal bleeding). 

Bloody discharge and menopause

Menopause is the point in your life when your oestrogen levels fall, causing your periods to stop. This does not happen overnight and often, women going through perimenopause can have changes to their periods for a few months or even a few years. If you notice any unexpected bloody discharge during menopause you should contact your GP. 

Once your periods have stopped for 12 months, you are in menopause. Bloody discharge after this may be a sign of something more serious. You should get checked if you get a postmenopausal bloody discharge. 

How to prevent bloody discharge

Bloody discharge at the start, during or at the end of your period is a sign that your body is working as it should. This means it cannot always be prevented. There are some things you can do to reduce your risk of unexpected bloody discharge, such as:

• getting regularly tested for STIs if you change sexual partners
• using hormonal contraception if your periods are irregular and your doctor feels this is suitable, as this can prevent bloody discharge between periods 
• using contraception such as a condom, which reduces your risk of STIs
• attend smear test appointments 
• washing your vagina with water and unscented soap, to reduce your risk of vaginal infections like thrush

If the cause of your bloody discharge is something that can be treated, speak to your doctor to find out more about your treatment options. 

Is bloody discharge a cause for concern?

Bloody discharge is often not a cause for concern if this happens at the start, during or end of your period.  If you have bloody discharge at any other time, have any other symptoms, are postmenopausal, or are pregnant you should speak to your doctor. 

When should I see a doctor about my discharge?

You should see a doctor about your discharge if it is suddenly different from normal, smells unpleasant, or you have other symptoms such as pain when peeing. You should also speak to your doctor if you have bloody discharge between periods, after sex, during pregnancy or after menopause. 

Sources

• Chlamydia (2021) NHS (accessed 14 March 2022) 
• Postmenopausal bleeding (2020) NHS (accessed 14 March 2022)
• Thrush in men and women (2020) NHS (accessed 14 March 2022)
• Vaginal discharge (2021) NHS (accessed 14 March 2022) 
• Vaginal discharge in pregnancy (2021) NHS (accessed 14 March 2022) 
• https://www.nhs.uk/conditions/ectopic-pregnancy/symptoms/ (accessed 14 March 2022) 
• https://www.nhs.uk/common-health-questions/womens-health/what-causes-a-woman-to-bleed-after-sex/ (Accessed 21/3/22)
• https://www.nhs.uk/conditions/pelvic-inflammatory-disease-pid/ (accessed 21/3/22)