Brown Discharge: Potential Causes and What It Indicates

When your reproductive system works well, it naturally eliminates the old material to create space for the new. Vaginal discharge is the fluid that is released from the vagina. This fluid is created by the uterus, cervix or vagina as they eliminate excess fluid and old cells.  

Vaginal discharge can vary in colour, ranging from normal to potentially alarming. Possible colours include  

• Clear
• White or off-white shades
• Pink
• Reddish-brown
• Yellowish-green
• Grey

Blood that exits the body rapidly is typically bright red. However, when the flow is slow, it can oxidise and become brown. This colouration may sometimes indicate a medical issue, such as hormonal imbalance or infection.

Is brown discharge normal?

Yes, it is common for brownish discharge to occur and is usually considered normal. Throughout your menstrual cycle, the quantity, colour and texture of discharge can change. One day, you might notice a thick, clumpy discharge, while on another day, it could be thin and watery. The bleeding can vary as well, appearing as dark brown discharge or light brown discharge, and can be bright red or even pink.

Causes

Before or after your period: At the start and end of your period, your menstrual flow tends to be slower. When blood exits the body quickly, it usually appears red. However, as the flow slows, the blood oxidises, which can cause it to turn brown. Hence, one can see brown discharge after or before the period. In some cases, if the flow is particularly heavy, you might notice black discharge.

Hormonal imbalance: Brown mucus discharge might be a sign of hormonal imbalance. Oestrogen plays a crucial role in keeping the uterine lining stable. When there is a lack of oestrogen, this lining can break down at different times, causing brown spotting or unusual bleeding. Low oestrogen can also lead to symptoms like:

• Tender breasts
• Trouble concentrating
• Mood swings
• Vaginal dryness
• Hot flashes
• Night sweats
• Insomnia  

To address these issues, a healthcare professional can suggest treatments, often involving hormone therapy, to help restore balance to your hormone levels.

Hormonal contraception: Birth control pills and intrauterine devices (IUDs) can cause spotting during the initial months as your body adapts to hormonal changes. Breakthrough bleeding is more likely if your contraceptive has low or no oestrogen. If oestrogen levels are low, your uterine lining may shed between periods, and this can appear brown if it takes time to exit the body. If spotting lasts over 3 months, consult a healthcare professional about adjusting your birth control. Missing pills can also cause temporary spotting.

Ovulation: Ovulation spotting usually happens around the middle of the menstrual cycle when an egg is released from the ovaries. As oestrogen levels peak and then drop, spotting may occur, which can be red, pink or brown and might be accompanied by clear discharge. Other ovulation signs include:

• Egg-white-like discharge
• Mild lower abdominal pain
• A change in basal body temperature

Ovarian cysts: Ovarian cysts are fluid-filled sacs or pockets that form in or on an ovary. In most cases, these are not a cause for concern. It may go away on its own after a few months. Sometimes, a cyst may not go away and can even increase in size. When this occurs, it might lead to symptoms such as brown spotting or sensations of pain or heaviness in the pelvic area.

Infection:  

Some sexually transmitted infections (STIs), like gonorrhoea or chlamydia, may not show symptoms initially. As they progress, symptoms may include painful urination, pelvic pressure, spotting or unusual vaginal discharge in colour or smell.

Bacterial vaginosis (BV) occurs when there is an imbalance in the normal bacteria in the vagina, leading to changes in the discharge’s texture, colour or odour. Some individuals may experience a thin, grey discharge with a fishy smell, while others may not have any noticeable symptoms at all.

Endometriosis: It occurs when uterine-like tissue grows outside the uterus, shedding without leaving the body, causing pain and brown discharge. Other symptoms include:

• Back pain
• Pain during penetrative sex
• Spotting between periods
• Painful bowel movements
• Constipation
• Nausea

Polycystic ovary syndrome (PCOS): It is a hormonal condition commonly marked by irregular menstrual cycles. You may have irregular or infrequent menstrual cycles, with intervals longer than 35 days. This delay between periods can lead to brown discharge. Other symptoms include:

• Acne
• Hirsutism (increased facial or body hair)
• Acanthosis nigricans (dark patches of skin seen near the folds of the neck, armpits, groin or breasts)
• Ovarian cysts
• Skin tags
• Thinning hair  

Implantation: It happens when a fertilised egg attaches itself to the lining of the uterus. It typically occurs about 1 to 2 weeks after fertilisation and can result in light bleeding that varies in colour, including brown. Other early signs of pregnancy may include:

• Cramping
• Fatigue
• Nausea
• Tender breasts
• Frequent urination
• Bloating

Ectopic pregnancy: A fertilised egg can sometimes implant in areas other than the uterus, such as the fallopian tubes, ovaries, abdomen or cervix. This condition is referred to as an ectopic pregnancy. In addition to brown spotting, an ectopic pregnancy may lead to:

• Low back pain
• Pain on one side of your abdomen
• Shoulder pain
• Weakness
• Dizziness
• Fainting

Miscarriage: Bleeding in early pregnancy does not always indicate a problem. However, it is crucial to inform your healthcare provider about any brown discharge or other unusual symptoms. Symptoms can appear suddenly and may involve a rush of brown fluid or significant red bleeding. Additional symptoms may include:

• Passing large blood clots or tissue
• Pain on one side of your abdomen
• Shoulder pain
• Diarrhoea
• Vomiting

If you suspect you are experiencing a miscarriage, it is important to seek immediate medical attention.

Lochia: It refers to the discharge and bleeding that occurs after childbirth or a miscarriage and can persist for up to 6 weeks. Initially, it starts as a heavy red flow. After a few days, the bleeding usually decreases and may take on a browner hue. Around 10 days in, this discharge shifts to a yellow or creamy colour before eventually tapering off completely.

Perimenopause: Menopause is reached after 12 consecutive months without a period, with the preceding phase called perimenopause, usually starting in your late 40s. During perimenopause, fluctuating oestrogen levels can cause irregular bleeding or spotting, ranging from brown to pink or red. Other common symptoms include:

• Changes in breast size or shape
• Sore or tender breasts
• Flushing
• Hot flashes
• Frequent urination
• Insomnia
• Night sweats
• Pain during penetrative sex

Conclusion

Brown discharge usually indicates old blood slowly exiting the uterus, particularly at the beginning or end of your period. If it appears at other times, it is generally not worrying. However, track when it happens, what it looks like and any accompanying symptoms. This can assist a healthcare provider in determining the underlying cause.