Brownish vaginal discharge

What is brownish vaginal discharge?

When the vaginal discharge becomes brownish in color instead of the normal clear or whitish color, it is termed brownish vaginal discharge. It is commonly experienced by many women and is often scary. It can be seen in many normal physiological conditions but can also be seen in conditions that need medical attention. Let us try to understand what exactly causes a brownish vaginal discharge and how to recognize when this discharge is significant and needs medical attention.

Why does vaginal discharge become brown?

Normal Vaginal discharge (see Vaginal discharge) is a normal and essential part of female reproductive system. It serves many important functions like cleaning and lubricating the vagina and preventing infections. It is usually colorless or whitish depending upon the different phases of the menstrual cycle.

Bleeding from anywhere in the female reproductive system exits your body through the vagina. When such bleeding is heavy, it quickly comes out and shows as red blood. When bleeding is slow and small in quantity, it does not flow out quickly and stays in your reproductive system for some time. Your body tries to remove the blood by breaking down the red blood cells (RBCs). The breakdown of RBC’s leads to release of pigment hemoglobin which further gets converted to another pigment called hemosiderin.

This hemosiderin pigment which is brown in color, gets mixed with normal secretions of vagina and cervix and is seen as brownish vaginal discharge.

Causes of Brown Vaginal Discharge

Brown discharge can be caused by many normal conditions, which usually do not require any evaluation or treatment. However, it may also be caused by certain pathological processes or diseases which warrant proper evaluation and treatment. Let us understand each condition one by one:

Menstrual cycle changes:  Normal menstrual cycle or periods occur every 28-35 days and last for 4-6 days in most women (see menstrual cycle in Ovulation Discharge). The flow starts and ends slowly and is fast or heavy in between.

So, during the beginning of periods and in the last days of periods, the blood stays longer inside, gets broken down by the body and becomes brownish instead of red. This altered blood, mixed with other vaginal secretions is seen as brown discharge. The appearance of brownish discharge at the beginning or end of your periods is a natural phenomena and there is no need for worry.

Ovulation bleeding: Ovulation means the release of egg by the ovary and is seen approximately 14 days before periods. Sometimes, light bleeding may be seen at the time of ovulation and is called ovulation spotting. It is due to sudden fall in the level of estrogen hormone when the egg is ovulating and usually lasts for 1-2 days. Like menstrual cycle changes, it is also a physiological change and should not bother you.

Perimenopausal bleeding: Before menopause, women have regular menstrual cycles due to cyclic hormonal changes in their body. After menopause, the cycles stop as the ovaries stop producing estrogen hormone.

But there is a transition period in between the two, known as the perimenopausal period, during which the production of estrogen by ovaries slowly keeps on decreasing and the periods slowly becoming lighter till they finally stop. This lighter menstrual flow takes longer time to exit the body. So it gets oxidized in the body and mixes with vaginal secretions to look like brown discharge. Since perimenopausal bleeding is due to the body’s own physiological change, it rarely needs treatment.

Hormonal fluctuations: Normal menstrual cycle is regulated by two main hormones – estrogen and progesterone. Fluctuations in the levels of these hormones can cause can impact your periods and cause both excessive bleeding or scanty bleeding. Heavy bleeding quickly exits your body as red blood but the scanty bleeding takes longer to come out and appears as brownish vaginal discharge.

These hormonal fluctuations can be either caused by too less or too much hormone production by the body itself or they can happen due to hormonal treatments like birth control pills, progesterone only pills, hormonal implants, hormonal releasing intra-uterine device etc. The treatment in such cases depends on the cause. So a gynaecological consult is necessary.

Post-coital bleeding: Sometimes, bleeding may be noticed after sexual intercourse. As discussed before, heavy bleeding shows as red blood but when it is small in quantity, it may be seen as a brownish discharge. There can be many reasons for postcoital bleeding, varying from simple cervical or vaginal tears to conditions like cervical polyps, Cervical inflammation (cervicitis), genital infections, early stages of cervical cancer (CIN) or advanced cases of cervical cancer. You should always seek a gynaecology consult if there is postcoital bleeding.

Genital infections: Any genital infection can cause the vaginal tissues to become inflamed, friable and bleed leading to an altered vaginal discharge, including a brownish vaginal discharge. In addition to discharge, these infections are usually associated with other symptoms like fever, itching, irritation, redness, swelling or a foul smelling discharge, depending on the particular infection. Proper diagnosis and treatment by a gynaecologist is mandatory for treatment.

Brownish vaginal discharge in pregnancy

Brownish vaginal discharge may also be seen in different phases of pregnancy and may mean different in each phase. Let us understand the causes and significance of brown discharge in various stages of pregnancy.

Brownish discharge early in pregnancy: 

• Implantation bleeding: When the fertilized egg attaches itself to the uterine wall, mild bleeding may be seen. This is called implantation bleeding and may show as a brown discharge. It usually goes away in a few days.
• Very early in pregnancy, usually 1 to 2 weeks post-conception, brownish discharge may be seen which is due to the uterine cavity not being fully filled with pregnancy in the early stages. So it may be normal to have brown discharge in early pregnancy.
• A brown discharge in early pregnancy may also be a sign of the pregnancy not growing well or an early miscarriage.
• Ectopic pregnancy: Sometimes there is a brownish discharge in cases of ectopic pregnancy when the pregnant sac gets deposited in the fallopian tube and does not reach the uterus. Endometrial lining which was ready to receive the baby starts shedding slowly under the impact of falling hormones.

So brown vaginal discharge early in pregnancy could be anything ranging from implantation bleeding to ectopic pregnancy. It is very important to visit your health care practitioner and get evaluated in case you are pregnant and having brownish discharge.

Brownish vaginal discharge late in pregnancy:

• Brownish vaginal discharge late in pregnancy may mean a sign of labor or preterm labor, depending on your gestational age.
• Cervical growth: Sometimes there is some growth (Polyp, fibroid, cancer) or erosion (wound or ulceration) on the mouth of your uterus which may lead to having brownish vaginal discharge or spotting.
• In some cases of pregnancy, there may be severe vaginal infection which may lead to vaginal walls becoming friable and inflamed leading to spotting or brownish vaginal discharge.

Any vaginal bleeding in late pregnancy should be immediately evaluated by a gynaecologist. So always consult your gynaec in case of such bleeding.

Diagnosis of Brown vaginal discharge

The diagnosis of brown vaginal discharge is done by your gynaecologist through a proper history, physical exam and doing some tests like blood tests, PAP smear, Colposcopy, Ultrasound etc, as deemed necessary by the treating gynaecologist.

Treatment of brown vaginal discharge

A thorough evaluation by a gynaecologist is necessary to decide which brownish discharge needs treatment and which does not. The treatment, when needed, depends on the cause. For example:

• Infections: treated with antibiotics
• Hormonal fluctuations: treated with supplementing or withholding hormones, as deemed right by the gynaecologist
• Surgical lesions: Cervical polyps, Cancers may need surgical excision
• Cervical or vaginal tears: may need suturing

Carry home message

While a brownish vaginal discharge may be innocuous, it may also indicate a pathological condition warranting thorough evaluation and treatment. So if you have a brown vaginal discharge which was not there earlier, you should always seek a proper gynaecology consult and act as per the gynaecologist advice. Stay healthy!

For more such interesting information on women's health, kindly visit our website Expert Gynae Care and our YouTube channel @drnidhigarg

To consult Dr. Nidhi Garg, please visit us at Kamal Hospital, Doaba Chowk, Jalandhar-144004 or Visit our website kamal Hospital jalandhar or Expert Gynae Care