You’re not on your period, but you see a little bit of color in your underwear. Is that blood? Discharge? Both?
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“Discharge happens when the cells of the vagina shed or slough off,” explains Ob/Gyn Oluwatosin Goje, MD. It’s a healthy, normal process, but sometimes, you’ll notice changes in your vaginal discharge. While some of those changes can be easily explained, others signify health concerns worth talking to your doctor about.
With brown discharge, it can be hard to tell. It could be a totally normal marker of the end of a recent menstrual cycle, or it could be something else, including a sign of a health issue.
Is brown discharge normal?
When blood mixes with vaginal fluid, the result is a brownish discharge. Sometimes, this is just a sign that your period has come to an end.
“Normal brown discharge happens at the end of your menstrual cycle,” Dr. Goje says. “When there’s a little left over from menses, often the body will biodegrade it so it doesn’t come out.” Sometimes, though, some of it makes it out of your vagina and into your underwear toward the end of your period, or even a day or two after it has finished.
But there are other causes of blood-tinged brown discharge, too. She explains.
1. Menopause-related changes
When you’re in menopause, a decrease in estrogen can cause the walls of your vagina to become thin and brittle, a condition known as vaginal atrophy. Your blood vessels shrink, and you may experience some vaginal bleeding.
Think about what happens if you blow your nose in the winter, when your skin is dry and chapped: When you pull the tissue away from your face, you sometimes notice streaks of blood mixed in with your nasal mucus (the medical term for snot). “That’s kind of what happens in the vagina during menopause,” Dr. Goje says.
If you’re in or approaching menopause and start to experience brown discharge, talk to your Ob/Gyn, who’ll want to make sure it’s actually vaginal discharge. “For menopausal patients, we always want to make sure that blood isn’t coming from the uterus, which can signify other issues,” she adds.
2. Bacterial vaginosis
This common infection is typically associated with greyish discharge, but for some people, it could look brownish, especially after it dries in your underwear.
Discharge from bacterial vaginosis (BV) is caused by a bacterial imbalance in your vagina, and it’s usually more noticeable around your period and after sex. It’s almost always accompanied by a fishy odor, a key signifier that the bacteria is out of whack down there. “When the bacteria that causes bacterial vaginosis interacts with blood or semen, it begins to flourish, which causes it to smell,” Dr. Goje explains.
If you think you have BV, head to your Ob/Gyn to get a prescription pill or cream that will help clear it up.
Blood in your discharge could also be the result of trichomoniasis, a sexually transmitted infection caused by a live parasite in your vagina and/or urethra. Just like a scratch on your skin can make you bleed a little, so, too, can this parasite aggravate your insides.
“There’s irritation happening in there, and sometimes that irritation leads to flecks of blood,” Dr. Goje explains. “By the time that discharge comes out, it’s brownish.”
Trichomoniasis can also cause white, yellow or greenish discharge that’s either thin or foamy, with a bad odor. Your doctor can test you for this common condition and write you a prescription that will kill the parasite.
Even a single drop of blood from your cervix or uterus can mix with vaginal fluid to create a brownish discharge. And though it sounds scary, it isn’t always a serious concern.
“The cervix is very fragile, and sometimes it can just bleed a bit,” Dr. Goje says. “Spotting” between periods is common in young women who’ve recently begun menstruating. But it can happen to anyone.
In other cases, abnormal bleeding can signify a health problem, so if it starts happening regularly (and especially if it’s accompanied by pain), it’s time to talk to your doctor.
When to call your doctor
The bottom line is that if you start experiencing discharge you’ve never had before, it’s time to check in with your doctor, especially if:
- You’re frequently spotting between periods or spotting at a rate and amount that’s unusual for you.
- Your spotting turns into heavy bleeding, especially if you feel pelvic pain.
- You start to notice changes in the color, texture or odor of your discharge.
- The changes in your discharge are paired with other symptoms like pain or itching.
“Keep an eye on your monthly discharge so you know what’s normal for you,” Dr. Goje advises.