Brown Discharge

What is normal discharge?

Normal vaginal discharge is usually a white, off-white or transparent fluid that is regularly expelled from the vagina. Vaginas are self-cleaning, so this type of vaginal discharge should not cause concern. Discharge is a mixture of unwanted cells and bacteria that helps to balance vaginal pH. In terms of texture, it can range from watery to thicker, more mucous-like expulsions. It is typically odourless, though a slight odour is neither uncommon nor abnormal. The amount of discharge may vary depending on factors such as pregnancy, contraceptives and ovulation.

What does brown discharge mean?

Vaginal discharge that is light or dark brown in appearance usually presents around or during menstruation. Blood oxidises when exposed to air, resulting in a brownish colour. However, non-period-related brown vaginal discharge may signal certain underlying causes of greater concern.

Causes of brown discharge (outside menstruation)

1. Pelvic Inflammatory disease (PID)

PID is an infection in women that spreads from the lower to the upper genital tract, resulting in inflammation of the upper genital tract. This can cause brown discharge outside menstruation. PID is often caused by sexually transmitted infections (STI) such as gonorrhoea and Chlamydia.. Long-term consequences of PID include ectopic pregnancy and chronic pelvic pain. 

Some preventative measures include practising safe sex and undergoing regular screenings with a health professional to check for STIs.¹

2. Ectopic pregnancy 

An ectopic pregnancy occurs when a woman’s egg is fertilised outside of the uterus, which is where fertilisation normally takes place. As previously mentioned, PID is a risk factor for developing an ectopic pregnancy, and a woman may experience vaginal bleeding as a symptom.

There are measures to can help reduce the risk of an ectopic pregnancy, including practising safe sex and quitting smoking.²

3. Uterine fibroids

Uterine fibroids are a common condition, characterised by non-cancerous tumours that many women experience throughout their lifetime. However, this condition tends to affect older women and women of African descent more frequently. Symptoms may be abnormal uterine bleeding, including brown discharge. 

To reduce the likelihood of developing uterine fibroids, it is suggested that women who are obese try to lose weight. Additionally, if deficient in vitamin D, it is recommended to take supplements advised by a health professional.

4. Implantation

Pregnancy involves four processes: implantation, decidualisation, placentation, and parturition (birth). Implantation is the initial interaction of the fertilised egg cell with the uterus. Successful implantation depends on the uterus’s competency in receiving the fertilised cell. If implantation fails to occur within a particular time frame, miscarriage may follow.  

In cases where natural implantation is unsuccessful, in-vitro fertilisation/IVF may be considered. It is also advisable to seek advice from a  health practitioner if your oestrogen levels are too high, as they may suggest ways to regulate your hormones.⁴ 

5. Vaginal infections and STIs

Vaginal infections and STIs can cause abnormal discarge, including brown discharge. Bacterial vaginosis (BV) is the most common cause of women seeking gynaecological primary health care. There is also evidence showing BV significantly increases the risk of developing STIs including Chlamidya, HIV and PID (outlined above). BV in pregnant women has also been linked to late miscarriages. 

To take preventative measures, one may consider taking a daily probiotic and additionally maintaining safe sex practices.⁵

When to seek medical attention

While brown discharge during or at the end of menstruation is normal, occurrences outside of your period may have other causes. Some of these causes may require attention from a registered health professional to receive effective treatment and further prevention advice.

Summary

Normal vaginal discharge is a white or transparent fluid that helps to clean the vagina and maintain its pH balance. Brown discharge is usually seen during or near menstruation due to oxidized blood. 

However, brown discharge outside of menstruation can indicate potential issues such as pelvic inflammatory disease (PID), ectopic pregnancy, uterine fibroids, implantation, or vaginal infections/STIs. Seeking medical attention is advised for brown discharge occurring outside of menstruation to receive proper diagnosis, treatment, and prevention guidance. 

Taking preventive measures like practicing safe sex, undergoing regular screenings, maintaining vaginal health, and following healthcare professional's advice can help reduce the risks associated with these conditions.