Brown discharge: Causes & when to be concerned

What should discharge look like?

Healthy discharge is typically white and clear[1], but it can vary in color, quantity and texture at different times during your menstrual cycle. Discharge can also vary depending on your reproductive stage of life, with potential changes to the appearance, consistency, color and amount of discharge during pregnancy, postpartum, perimenopause and post menopause. Brown discharge is one of the possible colors of discharge.

Is brown discharge normal?

Brown discharge is often caused by old blood leaving your body. It’s most common just before or just after your period, when the menstrual blood flow is slower. Fresh blood is typically red but once it comes into contact with air, it oxidizes, which can turn the blood from red to brown.

So, brown discharge can be normal, particularly if you notice it around the time of your period. But not all brown discharge comes just before or after your period, and it’s not always related to your period. There are some other causes of brown discharge, which may indicate an underlying issue. That’s why it’s important that you get to know what’s normal for you, so it’s easier to spot any changes. If you’re ever concerned about your discharge (of any color), it’s always best to speak to your doctor for personalized advice.

Common causes of brown discharge

There are multiple reasons why your discharge may be brown. Here are some of the most common causes, from your period to vaginal irritation.

Menstruation

Some people have brown discharge in the days before, during, and after their period. When your period is at its heaviest, it’ll typically be red. However, it’s normal for the color of your period blood to vary, and it can be brown on the lighter days[2] That means you may see brown discharge at the beginning and end of your period when the flow is slower, meaning the blood is exposed to air as it takes more time to leave your body, turning it brown through oxidation.

Ovulation

A small number of people experience spotting around ovulation, when an egg cell is released from an ovary, which typically happens once during every menstrual cycle (usually around two weeks before your period).

One study found that 5% of women experience light bleeding around the time they ovulate[3]. This is typically brown or pink in color, and is much lighter than a normal period. If it’s mixed with vaginal fluid, then it may appear more brown in color.

Ruptured ovarian cyst 

An ovarian cyst is a collection of fluid in a sac that is in or on an ovary. They’re very common and don’t usually require any treatment. 

Sometimes a cyst can rupture, which may cause a sudden, sharp pain, and a brownish vaginal discharge may occur[4]. Although a ruptured cyst sounds scary, in most cases, it’s not harmful and the pain can be managed with over-the-counter medications.

You should see your GP is you have symptoms of an ovarian cyst, such as:

• Pelvic pain
• Pain during sex
• Difficulty emptying your bowels
• A frequent need to urinate
• Bloating
• Changes to your period

If you have sudden, severe pelvic pain or have tummy pain and are also feeling sick or vomiting, you should call emergency services or go to the ER[5].

Early pregnancy

Implantation is when a fertilized egg cell attaches to the side of the wall of the uterus in early pregnancy. It happens soon after the female egg cell has been fertilized by sperm in the fallopian tubes, usually around eight to ten days after ovulation[6].

There aren’t usually any signs or symptoms of this happening — but sometimes, you may experience implantation bleeding. Even though there is currently no strong scientific evidence for this phenomenon,  it’s commonly believed to be caused by the fertilized egg coming into contact with the lining of the uterus as it implants in the uterine wall [7]. This can result in very light bleeding that’s brown or pink in color. It doesn’t usually last long — usually between three hours and three days. If bleeding lasts longer or is accompanied by other symptoms, seek medical advice [8].

Hormonal birth control 

Many people experience side effects when using hormonal birth control, and one of those may be brown discharge.

The most common side effect of the birth control implant is spotting, which can look like light bleeding or brown discharge. It’s most common in the first six to twelve months after having the implant inserted[9].

Some people also experience brown discharge or spotting as a side effect of using the birth control pill. With the combined pill you may have spotting as you adjust to the medication, but this usually just lasts for two or three months as your body gets used to new levels of hormones, after which time the side effects usually stop[10]. On the progestin-only pill (mini), you may experience some spotting even after the adjustment period is over. The mini pill must be taken at the same time every day. Even small variations can trigger spotting or irregular bleeding[11].

Cervical examination or gynecological procedures

If you’ve had a vaginal medical test or procedure, such as pap smear, hysteroscopy, or cervical biopsy, you may have some brown discharge afterward.

These procedures shouldn’t hurt, but they may be uncomfortable and because the tissue in your vaginal canal and cervix is sensitive, it can cause some light bleeding. Sometimes the dyes used during the exam, such as in a cervical biopsy, can cause a brown or yellow discharge or brown or black specks in your discharge[12].

Perimenopause

Perimenopause is the period of time when a woman’s body begins to transition towards menopause. During this time our ovaries begin to produce fewer hormones, leading to an eventual stop of periods. 

In this transitional phase, the levels of estrogen in your body fluctuate, with a fall in estrogen triggering typical menopause symptoms like hot flashes and vaginal dryness[13]. Another common sign of perimenopause is changes in your menstrual cycle. You may find that your cycle becomes longer or shorter than usual, and your flow may become lighter or heavier, which may mean that you have some spotting or brown discharge[14].

It’s normal to experience changes to your menstrual cycle during perimenopause, but you should always report any changes to your doctor. Keeping track of your cycle can help you to understand what’s normal for you, and make it easier to spot any changes to your usual patterns.

Postpartum bleeding

If you’ve recently given birth, you’ll experience some postpartum bleeding, known as lochia. This is a combination of mucous, tissue, and blood that your uterus sheds as it replaces its lining after you've given birth.

The postpartum recovery timeline is different for everyone, but lochia lasts a few weeks for most people. It’ll typically be quite heavy at first, and the blood will be red, but over the next few weeks, it will gradually decrease and the color will turn brown[15].

It’s a totally normal part of the postpartum period, but if the bleeding continues to be heavy after the first few days or is accompanied by clots, you should let your doctor or midwife know as you may need treatment.

Polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is a condition that affects how the ovaries work. The exact cause of PCOS is unknown, but it’s related to abnormal hormone levels in the body, including insulin. Many women with PCOS are insulin-resistant[16], producing higher levels of insulin to overcome this – which contributes to increased levels of hormones like testosterone in the body. It’s very common, thought to affect one in ten women in the UK, although not all of them will have symptoms[17].

For those who do have symptoms, one of the most common is irregular periods – or no periods at all. That means that, when someone with PCOS does get their period, the discharge can be brown because it's older blood.

If you suspect you have PCOS, you should speak to your healthcare provider – while there’s no cure for PCOS, there are treatments and lifestyle changes which can help to manage your symptoms and regulate your menstrual cycle[18].

Endometriosis

Endometriosis is a condition where tissue that is similar to the lining of the uterus (endometrium) begins to grow outside of the uterus in places such as the ovaries, fallopian tubes or the abdominal cavity.

Some of the most common symptoms of endometriosis include:

• Pain during or after sex
• Severe period pain
• Pain in your tummy and pelvic area
• Heavy periods
• Infertility

Brown discharge isn’t often associated with the condition[19]. However, some people do experience this symptom. That’s because endometriosis can cause your menstrual cycle to be irregular, and some people with endometriosis may experience spotting between periods, which can look like brown discharge[20]. 

But if you’ve noticed any changes to your cycle or your discharge and you think you may have endometriosis, you should always make an appointment to speak with your healthcare provider.

What should I do if I notice a brown discharge?

It can be alarming if you spot discharge that’s a different color to what you’re used to — but brown discharge is usually nothing to worry about. The key is understanding what’s normal for you. If you keep track of your menstrual cycle, then it’ll make it easier to spot any changes.

If you notice brown discharge, you should:

• Assess the timing: It can be very normal to have brown discharge at the start and end of your period. If that’s not normal for you, or if you have a brown discharge at any other time of the month, then you should speak to a medical professional.
• Look out for other symptoms: If you have other symptoms like pain, itching or a bad odor, then it may be a sign of an underlying condition or infection.
• Consider your lifestyle: Lifestyle changes like stress, as well as sexual activity and changes to your hormonal contraceptives, can cause spotting or changes to your discharge.

If you’re worried, it’s always best to consult your doctor. They can help determine the cause of your brown discharge and recommend any necessary treatment.

Causes of brown discharge that may require treatment

Sometimes brown discharge is normal and will go away on its own. It’s also occasionally a symptom of a condition like endometriosis or PCOS, and if you suspect that’s the case, you should speak to your doctor. In other rare cases, brown discharge may need treatment from a healthcare provider. This can include:

Miscarriage

One sign of miscarriage in early pregnancy is a brown discharge that may look like coffee grounds or a brown discharge with lumpy or tissue-like pieces. This is actually old blood that’s been in the uterus for some time and is coming out slowly. Miscarriage can also take the form of other bleeding including spotting, bright red bleeding, or clots[21]. In the cases of a missed miscarriage, there is no immediate bleeding, and medical intervention may be required to start the bleeding.

This can all seem quite scary, but, it’s important to remember that early pregnancy bleeding is quite common, and it doesn’t always indicate a miscarriage[22]. If you do experience any vaginal bleeding during pregnancy, you should always contact your doctor or midwife for advice. They’ll assess your personal situation and tell you if you need to take any actions.

Sexually transmitted infections

Sexually transmitted infections (STIs) don’t always cause symptoms, but sometimes you may experience unusual discharge – usually yellowish or green with trichomoniasis or chlamydia. 

While brown isn’t the typical color of discharge associated with STIs, they may cause irritation, which can cause bleeding. When mixed with vaginal fluids or discharge of another color, that can look like brown discharge. Additionally, STIs like chlamydia and gonorrhea can cause bleeding between your periods, which may look like brown discharge.

Infections, especially sexually transmitted infections (STIs), can sometimes cause brown discharge due to irritation and minor bleeding in the vaginal or cervical tissues. STIs like chlamydia, gonorrhea, and trichomoniasis often inflame the vaginal or cervical lining, which can cause small blood vessels to break and the blood to mix with regular discharge, turning it brown as the blood oxidizes[23,24]. The discharge may also have a stronger odor and be accompanied by other symptoms like pelvic pain, itching, or a burning sensation when you pee. 

Bacterial vaginosis (BV)

Bacterial vaginosis (BV) is a common vaginal condition — in fact, it’s the most common vaginal condition in women aged 15 to 44[25]. One of the symptoms of BV is a thin white or gray vaginal discharge, while other common symptoms include a strong fish-like odor (especially after sex), pain, itching, or burning in the vagina, and burning when peeing.

Brown discharge, then, isn’t one of the most common symptoms of BV. However, it can cause irritation in the vagina and cervical tissues — and this can cause bleeding. That blood may then appear like brown discharge. While brown discharge is often completely normal, if it’s accompanied by other symptoms of BV like a strong smell, itching, or pain when peeing, then you should speak to your doctor.

Start of labor

If you’re pregnant, brown discharge may signal that you’re going to go into labor soon. When you’re pregnant, there’s a plug of mucus in your cervix, which comes away before labor starts and may pass out through your vagina[26]. This can look like brown discharge and is known as a “bloody show”. 

It means that your cervix has begun to dilate — which means that you can expect to go into labor soon, although it may still be days away. While this is a normal part of labor, you should call your midwife if this happens to get advice.

Ectopic pregnancy

An ectopic pregnancy happens when a fertilized egg cell implants outside of the uterus. Unfortunately, ectopic pregnancies aren’t viable, and if an embryo starts to grow in a fallopian tube, there’s no chance of it developing properly — and it may put you at risk.

One of the symptoms of ectopic pregnancy is vaginal bleeding or a brown watery discharge[27]. As well as brown discharge, some other symptoms include:

• A missed period
• Pain down one side of your tummy
• Shoulder tip pain

More serious symptoms can include:

• Sharp, sudden, and intense pain in your tummy
• Feeling sick
• Feeling dizzy or fainting

If you notice any symptoms of ectopic pregnancy, you should speak to your doctor right away.

Cervical cancer

Rarely, brown discharge may be caused by cervical cancer. This type of discharge is often non-stop, and as well as brown it may be pale, watery, pink, bloody, or smell bad[28]. Early cervical cancer often causes no symptoms, but when there are symptoms, they might include abnormal vaginal bleeding or bleeding after menopause, and periods that are heavier and last for longer than usual. 

These symptoms can all be signs of many other more probable things and they don’t necessarily mean that you have cervical cancer — but it is important to get checked out if you have any symptoms. 

Cervical cancer is almost always caused by the Human Papillomavirus (HPV). HPV can cause cancer by changing the genetic information in the cervical cells, making them grow and divide uncontrollably. If you have regular cervical cancer screenings in a form of a pap smear or HPV test (consult with your healthcare provider which one is suitable for you), any changes in your cells should be caught many years before cervical cancer develops. Additionally, a vaccine for HPV is available. It doesn’t cover all types of the HPV virus, but it significantly reduces the risk of HPV-related cancers[29].

That’s why it’s so important to have regular screenings, including pap tests and HPV tests, both of which can help prevent cervical cancer or find it early[30]. Guidelines on when you should start getting these tests and how often you should repeat them vary from country to country, so check with your local healthboard for more information. We also have a yearly pap smear reminder in the Natural Cycles app, so you can easily keep on top of your regular screenings.

When to see a doctor

Vaginal discharge is completely normal — and “normal” is different for everyone. Brown discharge may be a regular part of your menstrual cycle, but if it’s unusual for you, you should speak to your doctor. 

Many people will experience brown discharge or spotting just before or after their period. But other symptoms like pain and odor may indicate something more serious that you should get checked out. Additionally, if you’re post-menopause or pregnant and have any bleeding, you should speak to your doctor.

Your doctor will be able to do some tests to establish the cause of your brown discharge, and they’ll be able to recommend the best treatment (if necessary) for your individual situation. 

Get to know your body better

Every menstrual cycle is different, which is why it’s so important to understand what normal means for you. With Natural Cycles, you can track changes throughout your cycle, including spotting and changes in the heaviness of your flow, making it easier to spot any changes to your norm.

Natural Cycles is the first app of its kind to be FDA Cleared for use as contraception. Not only can it help you learn more about the unique changes that happen during your menstrual cycle, but it can help you prevent pregnancy too! Find out how Natural Cycles works to get started.