Brown discharge before or after your period, what does it mean?

It has ruined a lot of pairs of light underwear, but more importantly: What does it mean and does it cause any harm? We answer these questions using Western Medicine and from Chinese Medicine.

What is normal menstruation?

Western medicine and Traditional Chinese Medicine (TCM) see menstruation differently. Western medicine considers a menstruation to be normal if it lasts up to seven days and causes few symptoms. The color of the blood, for example red or brown, isn’t mentioned specifically. TCM considers a menstruation to be normal if it lasts approximately four days, starts and ends with bright red bleeding and causes no symptoms. This is when the Yin and Yang energies are completely balanced. Yin stands for the feminine, damper, quieter, darker and cooler energy. Yang stands for the masculine, lighter, dryer, warmer, and moving energy.

What does brown discharge around your ovulation mean?

From the perspective of TCM, the ovulation is the transition from the Yin phase to the Yang phase. If you then suffer from brown discharge, there may be a heat pattern or stagnation. This means that your body and your energy pathways are not properly able to make the change fromYin into Yang.

From the perspective of Western medicine, spotting around ovulation is linked to the sharp hormone change that takes place around that time. In particular, the sharp drop in the hormone estrogen can be a cause of this. If you suffer from this occasionally, there is no reason to worry about it.

What are the causes for brown discharge before menstruation?

If you have some brown spotting half a day to a day before your period, then everything is okay. This happens to a lot of people and it is nothing to worry about. If this starts about three to four days before your period, then it can point to a hormonal imbalance. It’s good to know that your period doesn’t start until the day you bleed bright red, so the days with brown spotting don’t count.

Blood that stays in your body for several days to weeks becomes brown in color. Once you have had a period, there may be some small residue left in your uterus. Once your next period starts, this dark brown blood will be the first to leave your body. This usually takes only 1 to 2 days.

TCM names a couple of physiological causes that cause blood not to flow properly or to flow too slowly and thus result in brown discharge. Consider a tilted uterus or endometriosis where blood stays (longer) in the abdominal cavity. In the ideal situation, the blood flows smoothly but in these cases it may flow slower.

These are a couple of the causes:

Spleen Qi deficiency

Spleen deficiency often causes symptoms such as bowel issues, loose stools, and quickly feeling cold. The Spleen ensures that the blood is being held in the blood vessels. If this energy isn’t strong enough it breaks down the uterine lining a little too early. This causes the brown ‘stuff’ you sometimes find in your underwear.

Causes of Spleen Qi deficiency are either that you are doing too much physical activity (for example, doing very physical labor every day or excessive exercise) and/or your diet is not sufficiently spleen supportive.

To support the Spleen, it is best to eat nourishing and easily digestible foods. Warm meals and foods are better than raw and ‘cold’ foods such as cucumber, bananas and mint. Choose to eat a warm stew, for example, and let the cold drinks and smoothies be for a while. 

Kidney Qi deficiency

Kidney deficiency is also often manifested by a feverish feeling in the afternoon ("red flushes" on the cheeks) or feeling hot at night. The cause of Kidney deficiency often lies in being overworked (not necessarily just physically) and not taking enough moments of rest. This can cause the Kidney Yin, which stands for recovery and rest, to become empty. So it is important to create more moments of rest for yourself.

Blood stagnation

Often you take notice of this due to clots and painful menstruations besides spotting. Endometriosis can also be a cause, but also a ‘cold uterus’, because the cold clots the blood. It is a good indication that there is a problem with the blood circulation and the energy of the pelvic.

What is the cause of brown discharge after menstruation?

If you have had four days of good bleeding, for example, followed by 1-2 days of light brown discharge, then there is not much to worry about. If you find this brown discharge in your underwear for three days or even (much) longer, then it is wise to do something with it.

The TMC considers this to be a Spleen Qi deficiency. The Spleen energy must be restored after the menstruation to keep the blood within the blood vessels. If this energy is too low, it doesn’t work as well as it should and the result is that you may continue to suffer from brown discharge for days.

Treatment for Spleen Qi deficiency

If you suffer from this, it is a good idea to check if you do too much physical activity or if you need to make some changes to your nutritional pattern.

What does the Western medicine say about brown discharge before and after your period?

From the perspective of Western medicine, spotting around the menstruation, before as well as after, points to a hormonal imbalance. A normal cycle results from a good balance between the hormones estrogen and progesterone. There are several factors that can disrupt this balance. Think about hormonal birth control, like the pill or the hormonal IUD. Each form has a different amount of hormones and these may or may not be right for you. It can also disrupt the balance when you switch between different kinds of hormonal birth control. 

Causes of hormonal imbalance

Hormonal birth control

Birth control with just progesterone, like the hormonal IUD, Implanon, or contraceptive injection, ensures that your uterine lining remains thin so no egg can implant. If this becomes too thin, it becomes friable and that leads to a little bit of bleeding called spotting. 

STI

Sexually transmitted infections (STIs), like chlamydia, can also cause bleeding in between menstruations due to a local infection near the cervix. This isn’t necessarily just brown discharge, it can also be bright red and it can occur after having sex. This also applies to abnormal cells of your cervix. 

Niche

If you’ve had a c-section and currently suffer from brown discharge or brown bleeding especially after your menstruation, it could be the case that there is a so-called niche in your uterus. A niche is a cavity-shaped scar that has formed as a result of a c-section scar not healing properly. The scar has started to give way, so to speak, creating a cavity. The blood from your period can then accumulate in this cavity and cannot flow away easily. This can cause brown discharge. It is also possible that the c-section has created more blood vessels during wound healing that bleed more easily.

Infection

Do you have brown, smelly discharge, abdominal pain and/or itchiness, or recurring brown/pink slimy discharge without getting your period?? This could point to an abnormality or infection of the cervix.

Treatment of brown discharge before and after menstruation

Western medicine will often advise you to switch hormonal birth control or to quit taking it for a couple of months to allow the hormonal imbalance to recover. If you have a hormonal IUD, Implanon or contraceptive injection, you can take hormones, like Progynova which has oestradiol, which make sure that your uterine lining becomes a little thicker and and stronger.

A polyp on the cervix can be easily removed. Your doctor finds out by doing an internal exam with a speculum. The removal of the polyp can be done during a doctor’s appointment and does not have to be done surgically.

If you suffer from brown discharge irregularly or after having sex, and it can also be bright red, then it is important to get tested for an STI and to get a pap smear. The GP can treat your for the STI and can refer you to a gynecologist if needed if your pap smear result is abnormal. 

If you have had a c-section and suffer from spotting, then you can ask for a referral to the gynecologist. A sonohysterography is done to check if you have a niche and how big it is. A regular ultrasound doesn’t always show a niche, which is why the sonohysterography is done. If you don’t have a child wish anymore, then there are a couple of treatments available, like a hysteroscopy where they try to even out the nice or cauterize any easily bleeding vessels. 

Do you have abdominal pain and brown discharge with a bit of a smell? Make an appointment with your GP or gynecologist to get checked out. An infection can be annoying and should be fixed as soon as possible.

What does brown discharge mean when you are pregnant?

Physiologically speaking, there could be a blood vessel in the uterus that bursts which causes the (light) brown discharge. Or think about an implantation bleed, a polyp, or an infection. If you suffer from burst blood vessels, according to Traditional Chinese Medicine this often indicates a low spleen energy, but you can only make this diagnosis if you also often suffer from burst blood vessels/rapid bruising and show other signs of Spleen deficiency such as loose stools, feeling cold easily, and having a poor appetite.

What does brown discharge mean during the perimenopause and after the menopause?

Starting at age 40 (and sometimes earlier), the hormone progesterone and later the hormone estrogen decline. This is simply a consequence of aging. Without noticing you no longer ovulate every month, so progesterone production does not always get going properly. Often your periods become different and irregular. Spotting can also occur. You are more likely to see a polyp or fibroid (muscle ball) in or around the uterus in women. By the way, this more often results in heavy bleeding rather than brown discharge.

What is the treatment of brown discharge during perimenopause?

The fact is that hormonal changes come with age. That's just the way it is. With Chinese herbs and acupuncture, you can begin to nourish the Qi (life energy) and Kidney energy. This will be a customized treatment plan. From Western medicine, for severe menopause symptoms - in addition to lifestyle adjustments - hormone supplementation can offer a solution.

If you suddenly suffer from brown discharge with or without abdominal pain after the menopause, then it is wise to go see your GP to get examined. 

Last but not least

Everyone is different. It may be in your blueprint that you have a somewhat weaker Spleen energy, for example. If you bruise quickly, it could be a sign that your connective tissue is a little weaker. Your blood isn’t being held in the blood vessels then. 

All of the above are, of course, general insights. Ultimately, you will have to be looked at as an individual. Fortunately, there are more and more doctors and health professionals who "join forces" from Western medicine and Traditional Chinese Medicine and look at the body and mind in this way. Western medicine, treatments and supplements, possibly combined with acupuncture and Chinese Herbs can support your cycle and menstruation.