Brown Discharge

Brown discharge can be a normal body function keeping tissues healthy and protecting against infection and irritation. It is also sometimes referred to as “spotting” when the amount of discharge is small. The texture of brown discharge may be clumpy and thick. It plays a role in keeping your uterus (womb) healthy and clean by removing old blood and dead skin cells from its lining. Abnormal brown discharge, where fluid has an unusual appearance or odour or is accompanied by itching, irritation, or pain, can indicate that something is wrong. Brown discharge out with your period, during or after sex or when you are pregnant can be a sign of an underlying problem and you should always contact your doctor promptly if this happens to you.

Common causes of brown discharge include:

• menstruation (your period)
• ovulation discharge
• infection, including STIs (sexually transmitted infections)
• reaction to clinical procedures or tests
• implantation bleeding
• the contraceptive pill
• perimenopause (the transitional period before menopause)

Brown vaginal discharge is something most women experience. It can be nothing to worry about, but if you have discomfort, it has a foul odour, happens out with you period, happens during or after sex or occurs persistently it needs further investigation and treatment. Irregular brown discharge can happen when starting hormonal contraception but if your bleeding or discharge pattern changes after more than 3 months on your current contraception you should always get this checked out.

If you are pregnant and have brown discharge, this could be a sign of ectopic pregnancy or miscarriage.

The NHS advises you should call your midwife, GP or maternity triage immediately if you have any bleeding from your vagina during pregnancy.

Infections such as STIs can cause brown discharge. It can sometimes have a strong, unpleasant odour. STIs can be uncomfortable and require treatment to prevent further health issues.

Can brown discharge be a sign of infection?

Infection and inflammation can be a cause of brown discharge from your vagina. You may also have itching or irritation at the same time. There are several infections and types of inflammation that can cause brown discharge including:

• cervicitis
• STIs such as chlamydia trachomatis, trichomoniasis, and gonorrhoea
• pelvic inflammatory disease (PID)
• vaginitis
• rarely, brown or blood-tinged discharge can be a sign of cervical cancer or other gynaecological cancers.

A forgotten (retained) tampon can also cause brown discharge.

If you have an STI, it is important that you get it treated by a sexual health clinic. If an STI is left untreated, it can develop into pelvic inflammatory disease (PID), which can lead to infertility or chronic pelvic pain.

Before, during, and after your period, brown discharge can occur. It is a normal and healthy process, as it is how your uterus sheds its lining each month.

What does brown discharge mean before or after my period?

During your menstrual flow, blood exits the vagina from the uterus. When blood is leaving your body quickly, it is usually red. Blood flow is typically slower at the start and end of your period. During slower blood flow, it is possible for oxidation to occur and turn the blood brown or even black. This is brown discharge, and it is normal at the beginning or end of your period.

Brown discharge can also be due to ovulation related hormonal changes. This often happens around two weeks before your period, as you ovulate approximately 10 to 16 days after the first day of your last period.

Ovulation is the process where your ovaries release an egg for fertilisation. When this happens, your oestrogen levels are high. When the egg is released, your oestrogen decreases, and this can result in some bleeding which can cause brown discharge. If you think you have ovulation bleeding or brown discharge it’s still a good idea to contact your doctor to make sure there’s not any other underlying causes.

However, if you take a contraceptive pill, brown discharge may be a sign of something else. Normally, contraceptive pills prevent ovulation.

Is Brown Discharge a sign of pregnancy?

Brown discharge can be an early sign of pregnancy. If you are actively monitoring yourself for pregnancy, you may notice a small amount of bleeding, sometimes referred to as “spotting”. If you are concerned that you may be pregnant, you should take a pregnancy test. This is the best way to know for sure. If you have a positive pregnancy test with brown discharge or bleeding you should contact a doctor urgently as it’s important to check for conditions like an ectopic pregnancy which can also cause pain, dizziness, diarrhoea, urinary symptoms or vomiting.

How to stop brown discharge after your period

You cannot prevent brown discharge. It is a natural process. Sanitary pads can help with large amounts of discharge, or if you are concerned about odours.

To help avoid soreness, dryness, or irritation, use plain water to gently wash the skin around your vagina.

Do not:

• use perfumed or non-perfumed soaps or gels
• use scented hygiene wipes or deodorants
• wash inside your vagina (douche)

Bleeding, including brown discharge, can occur during and after pregnancy. There are a variety of pregnancy related causes, including:

• miscarriage
• ectopic pregnancy
• lochia (post-pregnancy)
• bleeding related to an abortion
• implantation bleeding (usually 10-14 days after conception)
• interference with cervix during sex or vaginal examination

Brown discharge is not always a cause for concern in pregnancy but you should contact your doctor or midwife immediately so they can examine you and check why it’s happening.

Miscarriage and ectopic pregnancy

Brown discharge during pregnancy can be a sign of a miscarriage or an ectopic pregnancy. An ectopic pregnancy is where a fertilised egg implants itself into the fallopian tubes, ovary, abdomen, or cervix. In cases of miscarriage or ectopic pregnancy, brown discharge is often accompanied with other warning signs, including:

• abdominal pain or cramps
• shoulder pain
• feeling dizzy, weak, faint, or lightheaded
• diarrhoea or vomiting
• passing urine more frequently or pain passing urine
• tissue, blood clots, or heavy pink fluid coming out of your vagina

If you have a positive pregnancy test and any of the above symptoms you should contact 999 or attend A&E immediately to make sure you get urgent medical treatment.

Lochia (post-pregnancy)

A discharge called lochia can appear after you have a baby. It can vary in colour and may contain some small blood clots. Seek the advice of your GP or midwife if you have discharge or bleeding after giving birth.

Abortion

Brown discharge can also occur after an abortion. If you have brown discharge having recently had an abortion, contact your GP or the abortion clinic.

Implantation bleeding

Brown discharge can be an early sign of pregnancy. If you are actively monitoring yourself for pregnancy, you may notice a small amount of bleeding, sometimes referred to as “spotting”. This can appear brown, red, or pink, and usually occurs in the first few weeks of pregnancy. This discharge can often have a stringy or gummy texture because it is old blood mixed with cervical mucus. This could be implantation bleeding, which occurs when a fertilised embryo embeds into the lining of your uterus.

However, every pregnancy is different, and not everyone gets implantation bleeding. If you suspect you have implantation bleeding you should contact your GP so they can rule out other causes.

Interference with cervix during sex or vaginal examination

Brown discharge can occur during pregnancy as the result of interference with the cervix during sex, or after a vaginal examination.

Brown discharge is not always a cause for concern during early pregnancy. However, the NHS advises that you should call your midwife or GP immediately if you have any bleeding from your vagina during your pregnancy.

Brown discharge during pregnancy trimesters

1st Trimester

Bleeding, including brown discharge, is not uncommon in the first trimester of pregnancy. For instance, a study in the USA found that as many as 25% of women reported bleeding in the first months of their pregnancy. According to the American College of Obstetricians and Gynaecologists, bleeding happens in the first trimester in 15 to 25% of pregnancies. There are many reasons for bleeding, and it is not always known why bleeding occurs. However, it is not an uncommon occurrence for pregnant women in their first trimester and does not always indicate a more serious health concern.

2nd Trimester

During both the second and third trimesters, brown discharge can occur as a result of small amounts of blood leaving your body with normal discharge. This is not usually a cause for concern, and often is the result of interference with the cervix during sex, or a vaginal examination.

3rd Trimester

Usually around 37 to 40 weeks into pregnancy you may begin to lose your mucus plug – a barrier of mucus which protects your baby from bacteria – and notice an increase in discharge that is brownish or pink. When your body prepares to go into labour, it is normal that your cervix releases the mucus plug. The release can happen all at once or in smaller pieces. Sometimes the mucus may appear clear, but it can appear as a brown discharge.

If the release of the mucus plug is accompanied by blood loss, or the mucus plug is very bloody or green or happens before 37 weeks, contact your midwife or GP immediately.

Is brown discharge during pregnancy a cause for concern?

Brown discharge is not always a cause for concern during pregnancy. However, you should always get it checked out.

The NHS advises that you call your midwife or GP immediately if you have any bleeding from your vagina during pregnancy.

In some circumstances, sex can cause bleeding. Because brown discharge is made up of old blood, it means that you can sometimes get brown discharge after sex.

Why do I have brown discharge after sex?

There are several reasons you can have bleeding after sex which can appear as brown discharge:

• infections, such as pelvic inflammatory disease (PID), or a sexually transmitted infection (STI), such as chlamydia
• damage to the vagina, including tears caused by childbirth, or due to dryness or friction during sex
• cervical or endometrial polyps (benign, non-cancerous growths in the lining of the cervix or the womb)
• cervical ectropion or cervical erosion (inflammation on the surface of the cervix)
• atrophic vaginitis (vaginal dryness caused by reduced vaginal secretions after the menopause)
• having sex around or at the time of your period or ovulation
• rarely, brown discharge after sex can be a sign of cervical or vaginal cancer

In all cases, you should contact your GP, midwife (if applicable), or a sexual health clinic promptly.

Menopause is normally diagnosed in women over the age of 45 who have not had a period for over twelve months. If you have vaginal bleeding after this time, you should speak to your GP about it. Bleeding can sometimes appear as brown discharge.

There are a number of causes of postmenopausal brown discharge. Some common ones are:

• thinning and inflammation of the vaginal lining (atrophic vaginitis) or womb lining (endometrial atrophy) – this is caused by lower oestrogen levels
• womb or cervical polyps – growths which are typically non-cancerous
• a thickened womb lining (endometrial hyperplasia) – this can be caused by hormone replacement therapy (HRT), being overweight, or high levels of oestrogen. It can lead to womb cancer
• rarely, postmenopausal bleeding is caused by cancer, such as womb or ovarian cancer

In some cases, the discharge may be lighter than brown in colour. If you have an infection, brown discharge could be mixed with yellow or white discharge.

It is important you contact your GP urgently to notify them if you have post-menopausal bleeding, including brown discharge. You should still contact your GP even if:

• it only happens once
• there is just a small amount of brown discharge
• you do not have any other symptoms
• you are unsure if it is brown discharge

Post-menopausal bleeding – including brown discharge – is not necessarily indicate a serious health concern, but it can be a sign of cancer. Therefore, it is important to notify your GP as soon as possible, because cancer is treated more effectively when it is identified sooner.

Perimenopause

The stage before the menopause – known as the perimenopause – involves hormonal changes which can cause bleeding, including brown discharge. This can be normal; however, it is still important to contact your GP and notify them.

Irregular bleeding is common during the first couple of months after starting hormonal contraception. Sometimes this blood can take longer than normal to leave the body and it turns brown. This is brown discharge.Types of hormonal contraception include:

• combined oral contraceptive pill
• progestogen-only contraceptive pill (mini pill)
• contraceptive implant or injection
• intrauterine system (IUS)
• contraceptive patch (transdermal patch)
• contraceptive ring

Brown discharge caused by contraceptive pills will normally resolve within the first 2 to 3 months of taking them. It happens because your body adjusts to the hormones they contain. It is more common if the contraception you are taking contains less than 35 micrograms of oestrogen. This is because if there is too little oestrogen in your body, your uterine wall can sometimes shed in between periods. If you have brown discharge for longer than three months, consult your GP.If brown discharge is caused by implants, it can last 6 to 12 months. In some cases, it can last longer though it’s always a good idea to contact your GP to check for any other underlying causes.Taking an emergency contraceptive pill can also cause brown discharge.You may also get brown discharge between periods if you:

• miss any combined pills
• miss any progestogen-only pills
• have an issue with your patch or vaginal ring
• are sick or have diarrhoea whilst on the pill

If you miss taking your pill, brown discharge typically stops when you get back on schedule with your pills.

Vaginal discharge, including brown discharge, is a normal process and is not always a cause for concern. It cannot generally be prevented. Brown discharge is a normal bodily process which occurs naturally. However, there are some circumstances in which it may be related to a health concern, as explained above.If you have bleeding during or after sex – including brown discharge – a health professional may recommend that you try using lubricating gels. You could also be referred to a specialist, such as a gynaecologist, by your GP.Sanitary products can be helpful if you have heavy or excessive discharge, or if you are concerned about odour. However, using them all the time can cause irritation. To help to avoid soreness, dryness, or irritation, gently wash the skin around your vagina using plain water.Do not use perfumed or non-perfumed soaps or gels, deodorants, or scented hygiene wipes. Do not wash inside your vagina (douche).

If you are pregnant and have bleeding – including brown discharge – from your vagina, the NHS advises that you call your midwife or GP immediately.

If you are not pregnant,you should still seek medical advice if you have any changes to your bleeding or discharge.