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Dark brown vaginal discharge: a norm or a sign of illness?

Dark brown spotting

Dark brown vaginal discharge appearing on a woman’s pad means that blood is released from the vagina, mixed with vaginal secretions. It is this color that is obtained when blood flows from the small vessel located not near the exit of the vagina but closer to the cervix. Another reason may be that blood remained for some time in the uterus, undergoing a chemical change, and then was released outside.

In any case, if the dark brown discharge from the vagina, even if not heavy, is accompanied by fever, abdominal pain, a feeling of unreality, loss of consciousness, and weakness, you need to urgently visit a gynecological hospital for examination and treatment.

When can dark brown vaginal discharge be considered normal?

- In the first days of menstruation;
- In the last two days of menstruation.

These two factors can be considered normal for the appearance of dark brown vaginal discharge provided that the woman in question is more than 10 years old, that the menstruation lasts no more than 7 days, and that the woman’s pad is changed not more than once every two or three hours for 6-7 drops. These conditions also apply to menstruation in women who have not entered menopause. That is, if the woman has not seen her period for a year now, and dark brown vaginal discharge suddenly appeared, even if not heavy, it is a reason to see a gynecologist.

- Once after an active vaginal sex or after such a sexual intercourse when the woman was not sexually aroused (for example,  rape). In this case, the vaginal secretions should not be heavy and/or repeated anymore. Constant discharge of blood after sex is a sign of disease.
- At the first sexual intercourse in a woman’s life as well as during several subsequent coitions.
- At the first sex after childbirth, especially if tears that were sewed up surgically accompanied the delivery.

- While receiving hormonal birth control pills, insertion of hormone-drenched intrauterine device or rings, as well as at emergency intake of Postinor after unprotected sexual intercourse. In this case, the vaginal discharge occurs around the middle of the menstrual cycle. It is not heavy and lasts for one or two days.

- In the middle of the menstrual cycle, a very small amount of dark discharge could mean that ovulation has occurred (11-14 days from the first day of menstruation).
- Implantation bleeding, that is, dark (or black or yellow) secretion for 7-10 days after conception will also be considered normal. This is the case when the embryo is implanted into the place prepared for it in the uterine lining. Such secretions appear most often when a woman is expecting the beginning of her period. If the dark discharge (usually very scanty) disappears instead of intensifying, this may indicate pregnancy.
- During pregnancy when some pelvic exams were carried out – speculum examination, ultrasound scan using a vaginal probe. This is because the vagina and the cervix are friable, rich with blood vessels, and can be easily injured.
- After an abortion: at first the blood is lighter and there can be clots. But by the 10th to 14th day, dark discharge usually remain.
- After cervical cauterization or other manipulation which can injure the mucous vagina or cervix.

When does dark brown discharge indicate a disease?

1)      Occurrence of such discharge in girls below 9 years old. This may indicate hormonal disorders, gynecological infections, and infections of the kidney, urinary tract or bowel (secretion on the panties may not necessarily be from the vagina). In this case, one needs to first see a pediatric gynecologist after which, if necessary, a pediatrician and pediatric endocrinologist can be consulted.

2)      Brown discharge in girls older than 12 years, which may be associated with their period or appear suddenly in the middle of their menstrual cycle. If a dark discharge is observed in the first and last days of menstruation, then this is normal. If such discharge appears irregularly, within some months after the first period, this can also be normal (formation of ovarian hormonal function), but can also be a sign of such diseases as:

- infectious diseases that can be transmitted not only sexually, such as hepatitis (Botkin’s disease), which can be contracted through dirty hands;

- blood-clotting disorders (especially if in addition to these secretions, the girl often has bleeding gums after brushing her teeth, there is nasal bleeding, and blood does not stop quickly after injection or injury);

- anomalies of genital organs (for example, two-horned uterus);

Dark brown spotting

- stress;

- malnutrition with lack of vitamins.

3) Dark brown discharge in women may indicate the following:

a) genital and uterine tumors, endometriosis;

b) sexually transmitted infections (particularly chlamydia and gonorrhea). In this case, the discharge is usually more abundant, it has an unpleasant odor, may be accompanied by fever and itching of the genitals. There is a connection with unprotected sexual intercourse;

c) injuries to reproductive organs;

d) blood-clotting disorders;

e) liver diseases (hepatitis C, hepatitis B, liver cirrhosis), diseases of the pancreas and thyroid gland;

f) beginning miscarriage.

4) Spotting during pregnancy, which is not associated with sexual intercourse or speculum examination, can occur only when there are serious complications in that menstrual period such as low location of the placenta that could lead to premature birth and placental abruption. In this case, even if the appearance of the discharge corresponds with the dates when the woman’s periods occur, one must still see a doctor immediately as these secretions may be the beginning of uterine bleeding, and they can be heavy and life-threatening.

How to examine the appearance of dark brown discharge

In addition to a survey, speculum examination and vaginal swab tests, special investigations including pelvic ultrasound scan and colposcopy are also carried out. The level of sex hormones is also determined. In some cases, the investigations cover not only the gynecological field but the whole body. Sometimes, dilatation and curettage can be carried out. This is done mainly in menopausal women and also as a life-saving measure in girls and young women, if the cause of the bleeding cannot be detected or stopped through usual methods.

In any case, if dark discharge appears suddenly, or it is not related to menstruation or vaginal examination, you need to consult a gynecologist. Lack of adequate diagnosis and proper treatment may not only adversely affect the health of the woman but also can be a threat to her life.