Brown Vaginal Discharge: What May It Mean

What is Brown Vaginal Discharge?

“Brown vaginal discharge is usually not something to worry about. However, if the brown discharge is accompanied by other symptoms like abdominal pain, vaginal itching, or a foul smell, it may indicate other underlying health problems that require medical attention.” - Dr Mrudula. M., Ayurveda Consultant at Nirva Health.

What does brown vaginal discharge mean?

Brown vaginal discharge is usually a mixture of normal vaginal fluids along with blood that has become darker due to oxidation. Brown-coloured discharge can occur normally towards the end of your monthly menstruation.

Common Causes of Brown Discharge

What leads to brown vaginal discharge? The causes are diverse, ranging from natural processes happening during your menstrual cycle and hormonal changes to more serious conditions like cancers. Here’s a detailed breakdown of the causes of brown vaginal discharge.

1. Menstrual Cycle-Related Causes

A brown vaginal discharge can occur normally as part of your menstrual cycle. Menstrual cycle-related causes of brown vaginal discharge are:

a) Menstruation:

Have you noticed brown blood towards the end of your cycle?

• During the first few days of your periods, the vaginal discharge is bright red in colour, and gradually, it turns darker.
• This happens because the discharged blood towards the end of your menstrual cycle is older and undergoes oxidation, causing the red colour of blood to change to brown. 
• Sometimes, a reddish-brown vaginal discharge may be present before your period. This is the old blood from your previous menstrual cycle exiting your body.

b) Ovulation:

• Some women experience a brown discharge in very minimal quantities around the 14th day or mid-cycle. This discharge or spotting is caused by ovulation bleeding that occurs when an egg is released from your ovary. This can last for one to two days.

c) Perimenopause:

• When you reach perimenopause (the transitional years before menopause), the hormonal fluctuations make your menstrual cycles irregular. This may result in incomplete shedding of the uterine lining during a menstrual cycle. During the next cycle, this old blood is shed, which becomes darker and appears brownish.

2. Early Pregnancy and Implantation Bleeding

Brown vaginal discharge occurs in many women during early pregnancy. But what causes it? The most common cause is implantation bleeding.

What is implantation bleeding?

When an egg gets fertilised, it attaches itself to the inner lining of the uterus (endometrium), typically in about 6 to 12 days after ovulation. When the fertilised egg attaches to the thick endometrium, it causes small disruptions in the blood vessels lining it, resulting in implantation bleeding. 

Implantation bleeding can be an early indicator that pregnancy has occurred. The bleeding is very light or spotty, brown in colour and lasts for not more than a day or two.

3. Other Pregnancy-Related Causes

Apart from implantation bleeding that happens in early pregnancy, there are other potential causes that may result in a brown vaginal discharge. These are:

a) Ectopic Pregnancy:

• Ectopic pregnancy is a condition where the fertilised egg gets implanted outside the uterus, most commonly in the fallopian tubes (and rarely in the cervix or ovaries). As the embryo starts to grow, it causes bleeding due to the damage to surrounding tissues and blood vessels. This bleeding is usually light and appears brown in colour.

b) Lochia:

Lochia is the vaginal discharge that occurs after a woman gives birth, which is a mixture of blood, mucus and uterine tissue. It can last up to six weeks. Lochia is divided into three stages:

• Lochia rubra (Days 1-4): Bright red discharge.
• Lochia serosa (Days 4-10): Pinkish or light brown vaginal discharge.
• Lochia alba (Day 10 onwards): White or yellow discharge.

Brown discharge occurs during the second stage of lochia, as a result of old blood and tissues being expelled out of the uterus. 

c) Miscarriage:

• Miscarriage means a sudden loss of pregnancy before the 20th week of pregnancy. If a miscarriage happens during early pregnancy, it causes a brown vaginal discharge that looks like “coffee grounds”.

4. Underlying Medical Conditions

Apart from menstrual cycle-related and pregnancy-related causes, women may experience brown vaginal discharge because of various health conditions and infections and require immediate medical attention.

a) Bacterial Vaginosis (BV):

• Bacterial vaginosis is a common vaginal infection caused by the overgrowth of bacteria. This can result in a thin, greyish or brown vaginal discharge with a fish-like smell.

b) Sexually Transmitted Infections (STIs):

• STIs like chlamydia, gonorrhoea and trichomoniasis can cause a brown, green or yellow-coloured vaginal discharge.

c) Pelvic Inflammatory Disease (PID):

• PID is an inflammation of the female reproductive system, usually caused by an untreated vaginal infection that spreads upwards through the cervix into the uterus. PID can cause a grey, green, yellow, brown or red vaginal discharge accompanied by lower abdominal pain.

d) Endometriosis:

• Endometriosis is a condition where the tissue that normally lines the insides of the uterus starts growing outside it (on the ovaries, fallopian tubes or on the intestines). This can cause vaginal bleeding or brown spotting in between your menstrual cycles.

e) Non-Cancerous Growths:

• Certain non-cancerous (benign) growths of the cervix and uterus, like uterine or cervical polyps and fibroids, can cause slight bleeding or spotting, which may result in a brown discharge if the expelled blood is old.

f) Polycystic Ovary Syndrome (PCOS):

• PCOS causes irregularities in your menstrual cycles and hormone levels, which can lead to brown discharge. Also, if a cyst ruptures, slight bleeding can occur, which may be expelled as a brown discharge.

g) Uterine and Cervical Cancers:

• Though not very common, cancers of the female reproductive system can cause brown discharge. Uterine and cervical cancers can cause bleeding in between your periods and pelvic pain. This blood gets expelled from the body as a brown vaginal discharge.

5. Other Potential Causes

Other common causes which may lead to a brown vaginal discharge are:

a) Foreign Body in the Vagina:

• Any foreign body forgotten or stuck in the vagina as a tampon, diaphragm or condom, can lead to infections and brown vaginal discharge.
• Hormonal Birth Control:
• Are you using hormonal birth control pills or injections? Know that this can cause fluctuations in your hormone levels, leading to light bleeding or spotting in between periods. It can also cause irregular menstrual bleeding, which results in old blood being expelled from the vagina as a brown discharge.
• Brown Vaginal Discharge After Sex:
• Sometimes, during sexual intercourse, minor tears happen in the vaginal walls, which might bleed lightly. This might go unnoticed. After a few days, this blood, mixed with vaginal fluids, exits your body and looks like a brown vaginal discharge.

When to Be Concerned

If you notice that the brown vaginal discharge is persistent or accompanied by other symptoms, it means that something is off and should be paid close attention. 

Warning Signs to Look Out For

Look out for these symptoms and make sure you consult a doctor if you have them:

• Persistent and excessive brown discharge
• Itching, burning, and swelling around the vagina
• Foul-smelling vaginal discharge
• Burning sensation while urinating
• Fever or chills
• Lower abdominal or pelvic pain or cramps
• Sores or bumps in your genital area
• Heavy bleeding in between your periods
• Pain during sex
• Other signs of pregnancy like nausea and missed periods
• History of sexually transmitted infections
• History of fibroids, endometriosis, polyps or cancers. 

When to Seek Medical Advice

Identifying the cause of brown discharge can help your doctor prescribe the right medicines and treatments for long-lasting relief. If you notice any of the above symptoms, you should consult a doctor immediately.

Treatment and Management Options

Brown discharge happening as part of your periods, during ovulation or pregnancy, is usually not a cause for concern and does not require any treatments. When does treatment become necessary? If it is due to infections or other underlying health conditions, the cause should be treated as soon as possible.

Treatment Options for Brown Vaginal Discharge

• Treating hormonal imbalances using medications and therapies.
• Surgical removal of uterine and cervical polyps and uterine fibroids.
• Antibiotics or antifungals to treat bacterial vaginosis and yeast infections of the vagina.
• Cancer treatments like surgery, radiation or chemotherapy, depending on the type and stage of cancer.
• Medications or surgery to prevent rupture of the fallopian tube caused by ectopic pregnancy.

Management Options for Brown Vaginal Discharge

Brown vaginal discharge can be managed using some simple techniques. These methods can help you keep vaginal infections away and catch any underlying health issues early.

• Keep your vaginal area clean and dry. Always wipe from the front to back to prevent spread of infections to the vagina.
• Avoid using harsh chemicals, scented products and over-the-counter douches to clean your genital area. Using a mild soap and water can prevent irritation.
• Get regular gynaecological check-ups done.
• Keep track of any changes in your vaginal discharge. This may help your doctor pinpoint the cause of your discomfort.
• Keep an eye out for symptoms like bleeding in between your periods, lower abdominal pain or cramps and foul-smelling vaginal discharge.

The Bottom Line

Brown discharge equals “old blood”. Oxidation causes the red colour of blood changes to turn brown.

Brown vaginal discharge is usually nothing to worry about. It may be a result of normal hormonal changes in your body brought on by your monthly menstrual cycles, ovulation, or pregnancy. 

However, if you notice that the brown discharge lasts longer than usual, is abundant and is associated with other symptoms like a foul smell, itching or burning sensation, or pain, it might be your body’s way of telling you that something is not right internally. 

Do not hesitate to seek medical help – A doctor can give you the right treatment and guidance you need.