Vaginal Discharge - What does brown, yellow, white and green mean?

The presence of mucous secretion, rejected by a woman’s body during the intermenstrual period, is a physiological phenomenon indicating adequate functioning of the organs of the reproductive system. Gynecologists claim that the consistency and volume of such secretions varies depending on the stage of egg formation, but, speaking of general characteristics, we can say that they have a viscous, rather liquid, consistency, are scanty and poorly expressed in color pigment. Women note that the color varies from transparent to white. But what to do if a representative of the fair sex notices spotting brown discharge in the middle of her cycle? Can this phenomenon be attributed to a physiological norm or is brownish daub a sign of pathology of the organs of the reproductive system? Let's figure this out together, based on the opinion of practicing gynecologists.

Conventionally, experts identify two large groups of reasons that provoke the rejection of brown discharge in the middle of the cycle. The division is carried out according to the principle of the “provocateur” belonging to a physiological norm or pathological processes. Let's take a closer look at these categories.

When is brown leucorrhoea normal?

The so-called brown spot is not always a sign of a problem in the body. Discharges that come from the genitals are not pathological if they appear:

• began (up to 2 days) before menstruation;
• after the end of menstruation (up to 3 days).

The reason for the appearance of brown leucorrhoea in the middle of the cycle may be hormonal changes in the body:

• When taking contraceptives
  . Leucorrhoea occurs during the first months (sometimes up to six months) after starting to take medications. They are not accompanied by additional symptoms and then disappear.
• After using medications
  emergency contraception (Postinor, Escapelle, etc.).

• During adolescence.
  The regularity of menstruation is established within 2 years from the onset of menarche (first menstruation). Therefore, the appearance of a scant bloody smear in the middle of the cycle is a variant of the norm during puberty.
• During menopause
  . Irregular cycles and spotting are common during menopause (from six months to a year after the cessation of menstruation).

Hormonal imbalances and the appearance of brown discharge can be caused by endocrine diseases.

Another non-pathological cause of brown spotting in the middle of the cycle is internal microtraumas that occur:

• During ovulation
  . After maturation, the egg ruptures the follicle and leaves the ovary into the fallopian tube.

  The rupture may be accompanied by the release of a small amount of blood, which, when oxidized, acquires a brown tint (from light chocolate to dark brown or black).

• After first coitus
  . Brown and even bloody discharge is a consequence of the destruction of the hymen. Sometimes spotting leucorrhoea appears after the first few sexual intercourses.

• After rough vaginal sex
  . If a woman is insufficiently aroused and there is no (or poor secretion of) lubrication in the vagina, microtraumas occur, accompanied by small bloody leucorrhoea.

Leucorrhoea that begins after sex, with an unpleasant odor, itching or pain, may be a symptom of sexually transmitted diseases.

Causes of vaginal bleeding by age group

In girls, bleeding before menarche (the first menstrual cycle) should always be carefully investigated). Possible causes of the pathology:

• vulvovaginitis;
• vaginal neoplasms;
• accidental injury;
• foreign bodies;
• violence;
• premature puberty;
• hormonal tumors;
• accidental use of certain drugs.

Causes of intermenstrual bleeding in adolescence and subsequent years:

• inability to ovulate;
• polycystic ovary syndrome;
• changes in coagulation;
• pregnancy (even unrecognized);
• sexually transmitted diseases;
• violence.

Causes of intermenstrual bleeding during the reproductive period:

The predominant cause is menorrhagia (heavy and prolonged menstrual flow), associated with benign organic pathologies - fibroids, polyps. In this category, bleeding due to problems during pregnancy is also likely.

Causes of intermenstrual bleeding in perimenopause: in this age group there is a very high risk of developing an organic malignant disease (genital cancer).

Causes of intermenstrual bleeding during menopause: during the postmenopausal period, benign causes predominate, such as endometrial and vaginal atrophy, endometrial polyps and, much less frequently, malignant tumors.

Discharge from a healthy woman

Normal indicators of the health of the female reproductive system are full discharge from the vagina and uterus. Every qualified gynecologist can explain why they go and visit regularly during an appointment. The mucous membranes of internal organs have their own protective microflora, which provokes the excretion of transparent mucus. Causes of natural discharge:

• microorganisms and epithelial cells of the vagina and uterus;
• vaginal lubrication. Observed after sexual intercourse;
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• protective function of the cervical canal.

There is another type - periodic bleeding menstrual flow. Traditionally, bleeding occurs differently for everyone and has an individual character. The daily amount is from 5-6 grams to 15-18 grams of liquid. The duration does not exceed 8 - 9 days. The rest of the menstrual cycle has a creamy or denser consistency of the composition.

The norm for the appearance of brown spotting impurities in vaginal discharge is the period before or after the expected menstruation. The duration should not exceed 2-3 days. Sometimes you can observe these signs during the period of ovulation.

Diagnostics

A gynecologist is involved in identifying the cause of the development of bloody discharge from the vagina. The woman requires a comprehensive examination using physical and instrumental methods. The diagnostic search is aimed at establishing the root cause of the symptom and assessing general disorders in the body caused by blood loss. The most informative are:

• Gynecological examination.
  The study of the mucous membrane of the vagina and cervix with vaginal speculum is necessary to identify pathological changes, erosions, signs of inflammatory processes or endometriosis. More valuable methods are colposcopy, cervicoscopy and hysteroscopy, which make it possible to detect microscopic foci of epithelial change.
• Ultrasonography
  . Using an ultrasound of the pelvic organs, the uterus and appendages are visualized, voluminous neoplasms, signs of diffuse growth of the endometrium, and other causes that cause odorless or odorless bloody discharge are detected. In difficult situations, when the doctor cannot verify the diagnosis, they resort to diagnostic laparoscopy.
• Visualization methods
  . Tumor growths can be visualized by contrasting the genital tract - hysterosalpingography. To clarify the diagnosis and assess the degree of infiltrative growth of tumors, modern research methods are used - CT and MRI of the pelvic organs.
• Biopsy.
  Identification of altered areas of tissue during instrumental visualization serves as an indication for collecting endometrial and uterine cervical material. Microscopic examination of cells assesses the degree of atypia, the presence of pathological inclusions or signs of malignant growth. Immunochemical analysis of materials obtained during the biopsy is also carried out.
• Diagnostic curettage
  . A total scraping of the mucous membrane of the uterus and cervical canal is a more informative method than a conventional biopsy, since it allows one to obtain a larger amount of material for histological analysis. Separate diagnostic curettage (SDC) is also prescribed for therapeutic purposes.
• Laboratory research
  . To clarify the cause of sanguineous vaginal discharge with an unpleasant odor, it is recommended to analyze a vaginal smear for microflora and culture it on nutrient media. Be sure to evaluate the female hormonal profile. General and biochemical blood tests make it possible to clarify the degree of posthemorrhagic anemia and metabolic changes.

Consultation with a gynecologist for bloody vaginal discharge

Discharge after sex

Normally, after intimate relations, the discharge should be mucous, without any foreign odor. Blood after sex, a feeling of discomfort and pain should be a reason to contact a gynecologist, especially if they appear repeatedly. Unpleasant symptoms can be physiological in nature (if it is the beginning of menstruation, first sexual intercourse, insufficient vaginal moisture), and in this case the woman’s condition can be easily corrected in accordance with the doctor’s recommendations.

In emergency cases, urgent hospitalization is necessary, but more often you can visit a doctor as planned, after which the specialist will prescribe treatment based on the identified pathology.

However, the reason may also be the development of gynecological pathology (inflammation, cancerous tumors, benign neoplasms, cervical erosion), which needs to be diagnosed (examination by a doctor, pelvic ultrasound, smears for flora and oncocytology) and timely treatment.

It is important to pay attention not only to the presence of blood during intimate contact, but also to other warning signs, so that you know what to do if there is blood during sex - relax or urgently consult a doctor for consultation and treatment. To clarify the reasons, the woman is prescribed several types of examination:

• examination on a gynecological chair;
• colposcopy to determine the condition of the cervix;
• performing an analysis of vaginal smears to exclude sexually transmitted diseases;
• pipel biopsy;
• Ultrasound to determine the condition of the endometrium;

• hysteroscopy (for regularly recurring bleeding).

If you suspect a precancerous condition of the tissues of the cervix, endometrium, or external genitalia, consultation with an oncologist is required.

Causes of bleeding

When bleeding appears in the middle of the cycle without pain or itching, and the discharge does not smell unpleasant, the symptom is almost always provoked by physiological factors:

1. Ovulation
   . The release of a mature egg is accompanied by a change in hormonal levels due to increased estrogen synthesis. On the 13th day of the cycle, spotting, if there are no gynecological diseases, is almost always caused by ovulation.
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2. Current pregnancy
   . At the time of implantation of the fertilized egg into the uterus, there is often a little bleeding from the vagina. Bloody discharge in the middle of the cycle without pain can occur any day after menstruation, but more often it occurs on the 15th day of the cycle if there was unprotected intimate contact before that.

3. Microdamage to the vagina
   . Active sex, accompanied by damage to the mucous membrane. Reasons: inappropriate or large size of the partner's organ. One-time minor bleeding in the middle of the cycle after sex is not dangerous. If the situation repeats and the peeing is not associated with coitus, then you should look for another reason.

4. Taking oral contraceptives
   . On the 16th day of the cycle, bleeding often occurs when hormonal contraceptives are taken.

5. Precursors of menstruation
   . Bloody discharge that appears on the 18th day of the cycle can signal that menstruation will begin soon.

The causes of bleeding in the middle of the cycle, even if there are no other signs of deterioration in health, are not always physiological in nature. If blood is released for several days or bleeding appears regularly, you need to undergo an examination and find out the cause.

Treatment

Help before diagnosis

The appearance of bloody vaginal discharge that is not associated with uterine involution in the postpartum period or natural menstrual bleeding is an indication for immediate medical attention. Attempts to independently treat the disorder using traditional methods or medications often lead to serious complications in the genital area and other organs. If brown discharge is accompanied by pain, you should not use analgesics from the NSAID group, which increase bleeding.

Conservative therapy

Medical tactics, first of all, depend on the degree of blood loss and the cause of the formation of reddish or brown discharge. For minor brown or bloody discharge, etiotropic therapy for the underlying pathology is indicated; massive blood loss requires the use of specific hemostatic agents. Physiotherapy methods are not recommended. To treat patients with complaints of vaginal bleeding, the following are used:

• Coagulants
  . The medications are designed to stimulate the formation of blood clots and quickly stop bleeding. They are prescribed only for heavy bleeding under the control of coagulogram parameters.
• Hormonal drugs
  . Bloody discharge caused by impaired ovarian estrogen secretion requires specific therapy. Estrogen and progesterone agents are used.
• Anti-inflammatory drugs
  . Reduce the amount of inflammatory mediators. Effectively reduce pain and promote healing of defects in the epithelium of the genital tract.
• Antibacterial agents
  . Indicated for foul-smelling discharge and signs of infection. Depending on the reasons, etiotropic medications are used: antibiotics, antiprotozoal, antifungal.

Surgery

The ineffectiveness of conservative therapy for extensive endometriosis is an indication for excision of endometrial growths followed by cauterization. For ovarian endometriosis and the formation of “chocolate” cysts, surgical laparoscopy and oophorectomy are indicated. For cervical erosions, cauterization is performed using laser coagulation. If polyps of the uterus or cervix are detected, they must be removed. To reduce trauma, endoscopic excision of the polyp is used.

In order to stop uterine bleeding, the main feeding arteries are ligated; if this method is ineffective, the uterus is amputated. Surgical interventions are performed for large benign fibroids to prevent malignancy or profuse bleeding. The method of choice is enucleation of pathological formations with preservation of the organ and restoration of reproductive function. In case of malignant lesion, extirpation of the uterus and appendages may be required, which is combined with antitumor treatment (radiation therapy and chemotherapy).

Discharge associated with pregnancy

Brownish leucorrhoea in the middle of the cycle may indicate the beginning or end of pregnancy (miscarriage). Why is this happening?

When a fertilized egg attaches to the uterus, the endometrial vessels may be slightly damaged. The released blood stains the mucus. Sometimes mild spasms may occur.

Heavy discharge, which is accompanied by severe pain, nausea and cycle disruption, can be a symptom of an ectopic pregnancy.

If the fertilized egg detaches from the endometrium (due to the non-viability of the fetus or the presence of scars and adhesions in the uterus), a miscarriage occurs, which is accompanied by slight bleeding (duration - up to 48-72 hours).

When to worry: signs of illness

Mid-cycle spotting, the causes of which are not related to normal physiological secretions, may be a sign of a gynecological disease. You should pay special attention to your health if leucorrhoea is accompanied by the following symptoms:

• unpleasant odor or heavy discharge;
• pain or cramping in the lower abdomen (moderate to severe);
• itching and burning;

• painful sexual intercourse;
• general intoxication (fever, weakness);
• long period of discharge (from several days);
• the appearance of blood clots;
• regular discharge (appears over several cycles).

Many serious gynecological diseases (cancer, polyps, fibroids, etc.) can be asymptomatic in the early stages, so delay in diagnosis and treatment is deadly

Brown spotting as a symptom of the disease

Brown leucorrhoea can be one of the symptoms of gynecological diseases. Often the appearance of spotting is caused by damage as a result of injury or infection of the mucous membrane of the reproductive organs.

The consequences of these diseases are very serious: from infertility to disability and death.

Therefore, it is necessary to carry out diagnosis as early as possible.

What is the danger?

There are cases when it is simply necessary to seek help from a specialist after detecting brown discharge, since spotting is a clear sign of abnormalities. For example, bleeding after sex is the first sign of diseases of the reproductive system. However, if the spotting is not accompanied by additional symptoms, for example, an increase in body temperature, then discharge after sexual intercourse may indicate the approach of menstrual bleeding.

The strength of the discharge also matters.

So, with an ectopic pregnancy, the discharge of blood can be very copious. It is worth noting that this condition is extremely dangerous for women. Dark brown spotting is most often referred to as metrorrhagia and intermenstrual bleeding.

This phenomenon is typical for women at any age and can appear as a symptom of pathology or be an individual feature of the body. If there is spotting in the middle of the cycle, the doctor may prescribe special medications. The most common diseases that cause spotting are:

• adnexal tumor;
• fibroma;
• malignant neoplasm in the uterus;
• sarcoma;
• cervical cancer or erosion;

• endometritis;
• not external adenomyosis.

These diseases are extremely dangerous and not only provoke changes in the cycle, but some can be fatal. In addition to dangerous diseases, bleeding can occur for other reasons that are less life-threatening, but can also lead to reproductive dysfunction and other unpleasant consequences.

Treatment and reasons for choosing a therapy method

Treatment depends only on the underlying cause of the bleeding. Once identified, drug therapy (dysfunctional causes) or surgical intervention (malignant formations) may be required.

A woman should always choose the most appropriate treatment, including taking into account her age or her desire to have children. This allows you to increase patient adherence to therapy, as well as achieve maximum success.

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