Vaginal discharge: normal and pathological. Or what a woman needs to pay attention to.

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.

Ultrasound for brown discharge

Ultrasound examination is the simplest, most accessible, safe and quite informative diagnosis. The sound wave penetrates the body through a special sensor, is reflected and returns with the necessary information, which is displayed on the screen in the form of a picture.

Thanks to this process, a specialist can identify many deviations from the norm and make an accurate diagnosis. Ultrasound examines the ovaries, uterus, and fallopian tubes. The procedure is prescribed by a doctor if there are uncharacteristic symptoms, including brown discharge in women.

Ultrasound examination is carried out in several ways: transrectal, transabdominal, transvaginal.

Each technique requires special preparation, but there are a number of general rules:

• a few days before the examination, it is necessary to exclude from the diet foods that cause gas formation, carbonated and alcoholic drinks;
• delay diagnosis if barium x-rays have been performed within several days;
• Before the event you must take a shower and put on clean underwear.

Transabdominal ultrasound is performed on a full bladder, and transvaginal ultrasound on an empty one. A gynecological examination is recommended to be done in the first week after the end of menstruation.

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.

What kind of diagnostics are needed for brown discharge?

If a brown secretion appears, a specialist may prescribe the following diagnostic measures:

Smear for microflora, cytology

The analysis reveals pathological changes in tissues. Biological material is taken from the cervix and studied in the laboratory. Thanks to this type of diagnosis, it is possible to identify various dangerous neoplasms and inflammations in the early stages and promptly select and prescribe effective therapy. The result of the analysis is of two types: positive and negative. In the first case, the indicators indicate that pathological processes were found in the human body. A negative analysis indicates a healthy state of the uterus and the absence of changes in the cellular structure of the epithelium.

Colposcopy

A gynecological examination using a specially designed microscope is carried out for the most detailed examination of the cervix and cervical canal. Detects erosion, precancerous conditions, and oncology in the early stages.

A colposcope is a device on a tripod with illumination. The device is equipped with lenses to enlarge the image and obtain more detailed information. All segments of the cervix are viewed due to the rotation of the mechanism.

Tests for sexually transmitted diseases

To determine the presence/absence of an STI, a specialist prescribes tests to choose from, such as: RIF, smear for bacterial culture, ELISA, for antibodies, for oncogenic subtypes. The popular and most informative test for the presence of sexually transmitted infections is PCR. This type of diagnosis makes it possible to identify the pathogen at the earliest stages by determining its DNA.

Cervical biopsy

During the examination, the doctor takes a certain part of the tissue for analysis, which is examined and tells about the pathologies the woman has. The material is taken immediately after menstruation or in the first phase of the menstrual cycle. Before the procedure, permission from the patient is required, which is provided in writing.

Histological examination of the endometrium using curettage

Diagnostics makes it possible to determine in the early stages the type of tumor, its malignant or benign nature. Using pieces of tissue, deviations from the norm and the condition of internal organs and systems are revealed, which are currently being examined.

Seeing a doctor in a timely manner will help you avoid a number of dangerous health problems. Modern medicine allows some tests to be performed at home. The doctor goes to the patient’s address and collects biological material in conditions that are comfortable for the woman.

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.

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 see a doctor

You should make an appointment with a doctor if you have the following additional symptoms:

• unpleasant odor from the vagina;
• discomfort in the intimate areas: burning, itching, pain;
• pain of varying intensity in the abdominal area;
• bad feeling;
• heat;
• rash, urticaria and other external manifestations in the groin and vagina.

It is also necessary to visit a specialist if there is prolonged, heavy discharge.

If the discharge is profuse and accompanied by fever, low blood pressure and other negative symptoms, you should call an ambulance.

Methods for diagnosing gynecological diseases:

• Calling a gynecologist to your home
• Diagnosis of gynecological diseases
• Diagnosis of sexually transmitted infections in women
• Colposcopy
• HCG tests
• Ultrasound during pregnancy
• Pelvic ultrasound
• Diagnosis of sexually transmitted diseases
• Fetal ultrasound
• Ultrasound of the mammary glands
• Ultrasound during pregnancy
• Transvaginal ultrasound
• Ultrasound of the ovaries
• Ultrasound of the uterus
• Cervical smear
• Vaginal smear
• Hormone tests
• Tests for sexually transmitted infections

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

How to treat abnormal vaginal discharge

Treatment of problematic discharge should always be carried out with the participation of a doctor after a thorough diagnosis.

For bacterial infection and inflammation associated with it, antimicrobial drugs are prescribed. Antibiotics are prescribed orally and locally in the form of suppositories, creams, and ointments.

For fungal infections, antifungal drugs are prescribed. It is worth remembering that thrush is a local manifestation of extensive fungal damage to the body, and its treatment is not limited to suppositories and creams. The bulk of the fungus is located in the intestines, so it is worth treating the entire body as a whole, and not just the vagina.

For viral infections, antiviral drugs are prescribed. Viruses are dangerous organisms, and doctors have not yet learned how to effectively treat them. Increasing immunity plays a vital role here.

If tumors appear, they can be treated conservatively or removed. Here, the decisive role is played by the nature of the neoplasm - benign or malignant - and the speed of its development.

In case of intrauterine pregnancy with a threat of miscarriage, the patient is sent to the hospital, the condition of the uterus, placenta, and fetus is examined. In case of an ectopic pregnancy, immediate removal of the fertilized egg from the woman’s body is required.

In any case, when unhealthy discharge appears, very careful hygiene is required, since many pathological discharges corrode the skin of the genitals. Sometimes the doctor prescribes baths with medicinal solutions and douching.

There are many traditional methods for treating discharge. They sometimes help, but sometimes they can blur the clinical picture and complicate the diagnosis and treatment of the disease. Among the folk methods, washing with herbal decoctions is considered safe and useful. Chamomile, calendula, St. John's wort relieve inflammation, increase local immunity and soothe irritated skin. Under no circumstances should foreign objects be inserted into the vagina, as some folk recipes advise. This can harm the microflora and injure the already irritated vaginal mucosa.

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.

Brown discharge when menstruation is late

Menstrual irregularities with the release of brown secretions can occur against the background of the following physiological factors:

• Hormonal therapy.
  At the initial stages of taking hormones, the body is rebuilt and sometimes this process is accompanied by a delay in menstruation and the appearance of an uncharacteristic secretion. In most cases, everything returns to normal after a short period of time.
• Climax.
  Cycle disturbances are a completely normal occurrence in the initial stages of menopause. During this period, the ovaries begin to work slowly and gradually their functionality completely fades away. Delayed menstruation and discharge are accompanied by constant weakness, increased/decreased blood pressure, frequent mood swings, rapid heartbeat, ebb/flow, and heavy sweating.
• Childbirth.
  After a woman gives birth to a child, menstruation may be absent for some time. During the postpartum period, brown liquid very often leaks from the vagina, which may be a consequence of accumulated endometrium, injuries or lochia, which are intended to naturally cleanse the body.

The above manifestations do not require treatment. A doctor's help is necessary if, during retention and discharge, pain, itching, burning and other discomfort, and an unpleasant odor appear. All these symptoms indicate the development of various gynecological, inflammatory, and infectious diseases.

Also, disruptions in the menstrual cycle with the appearance of brown secretions can occur against the background of sudden weight loss, regular nervous strain, stress, and hypothermia. The problem often manifests itself when there is a change in climate, time zone, obesity, or taking certain medications. In this case, it is important to reconsider your lifestyle.

Answers to frequently asked questions:

• How to get tested for gynecological diseases?
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• Female doctor
• Diagnosis of sexually transmitted infections in women
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• Pediatric gynecologist
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• Paid gynecologist

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.

Prevention for brown discharge

To prevent the occurrence of uncharacteristic excretion it is necessary:

• visit a gynecologist regularly;
• observe the rules of personal hygiene;
• monitor your health;
• do not wear tight underwear made from non-natural materials;
• eat right and lead an active lifestyle;
• exclude smoking, alcohol;
• monitor your weight;
• control hormonal levels;
• avoid nervous tension and stressful situations;
• protect yourself with condoms and avoid casual sex.

It is important to take the correct approach to the selection of medications, which should be prescribed by qualified specialists.

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Monthly cycle

To suspect that bleeding or spotting are pathological phenomena, a woman must clearly know what her cycle should be like. Of course, every experienced representative of the fair sex knows how many days between menstruation is the norm for her. How many days there should be between menstruation is an individual concept. Some people have a cycle of 30-35 days, for others a cycle of 24 days is normal. However, the average cycle is 28 days. Although from month to month it can fluctuate and be 24-27 days.

How is a cycle counted? It begins on the first day of menstruation and ends with the beginning of the next menstruation. Therefore, if a mature woman experiences something similar to her period after 2 weeks, starts again a week later, or her period comes for the second time in a month, the reasons for this will be determined by a doctor, who should be contacted immediately. But if a young girl has her period for the second time in a month, this may indicate the formation of a cycle. In such a situation, if your period comes 2 times a month, this is normal. Girls often write about such manifestations on every thematic forum.

However, if the onset of menstruation is several days ahead of schedule, or the interval between periods is several days longer, you should not sound the alarm and take any steps ahead of time. This can happen due to stress , too intense training, fatigue, climate change, etc. Sometimes the reasons why your period started 10 days earlier are also associated with such phenomena. It happens that the lower abdomen hurts for some time, but menstruation does not begin - a similar phenomenon can also be associated with overexertion or stress.

Clinic of pediatric and adolescent gynecology in St. Petersburg

If a girl has health complaints, she notices changes in the nature of vaginal discharge, the color has become darker, pain has appeared, and her general health has worsened, then this is a signal to immediately consult a doctor. In St. Petersburg, full gynecological support for children and adolescents is provided by experienced specialists from our clinic. We accept all questions regarding diagnosis, treatment, and preventive examinations. Contact us! Call us at the phone number listed on the website and we will answer all your questions.

Brown discharge in girls

The release of brown secretion in teenage girls is a normal manifestation of puberty, but in some cases this symptom signals inflammatory processes or the presence of infection. Since a large percentage of girls begin sexual activity before reaching adulthood, discharge may indicate problems that arise in adult women: sexually transmitted diseases, ectopic pregnancy, inflammation.

The first menstruation can be very scanty, similar to the usual spotting with the release of pieces of the endometrium. This is normal if the menstrual cycle subsequently returns to normal. If there is pain, itching, burning, unpleasant odor and other negative symptoms, parents should urgently make an appointment for their daughter to see a doctor and undergo all prescribed examinations.

Brown daub with an unpleasant aroma in virgin girls may indicate the development of bacterial vaginosis, which occurs against the background of decreased immunity. In this case, you will also need the help of a qualified specialist.

Which doctor should I contact if I have brown discharge?

For various gynecological disorders, it is recommended to make an appointment with a gynecologist. A specialist of this profile will conduct a professional examination, prescribe diagnostic measures, identify the cause of the pathology, and select a safe, effective treatment.

If a sexually transmitted infection is suspected, the patient is referred to a venereologist. In case of hormonal imbalances, see an endocrinologist. You can also initially contact a therapist, who will refer you for examinations and, based on their results, decide which highly specialized doctor the woman needs.