Most women who haven't passed through menopause yet have clear or white discharges several times a month. Mild smelling or odorless, a clear discharge means that estrogen levels are up, the way they are during the first half of a woman's menstrual cycle or during pregnancy.
A brown discharge has a different meaning. One possibility with a brown discharge is pregnancy. The brown substance can be "old" clotted blood released during the implantation of the embryo. Typically this blood will be noticeable as if a woman's period had arrived a day or two early. The problem with interpreting this symptom is that the symptoms of early pregnancy, such as swollen breasts, bloating, headaches, acne, and mood swings can be due to pregnancy or they can be due to PMS. If along with brown discharge and PMS/early pregnancy symptoms there is also morning sickness, then early pregnancy is a lot more likely, although only a pregnancy test (which can be done at home as soon as 11 days after conception) can tell for sure.
Many times a brown discharge doesn't mean a woman is pregnant. In these cases, the underlying cause of the discharge may be:
- PCOS, or polycystic ovarian syndrome. There are women who have ovarian cysts who don't have PCOS, and there are women who have PCOS who don't have ovarian cysts. If the problem is the collection of hormonal imbalances that cause the full range of symptoms known as PCOS, however, brown discharge is likely to be accompanied by acne, facial hairs breaking out, flushing skin, and acne, more than PMS symptoms. It's not unusual for women who have PCOS to have disturbances of appetite, but not the morning sickness associated with early pregnancy.
- An ovarian cyst that isn't caused by PCOS (that is, without the hormonal imbalances associated with polycystic ovarian syndrome) can cause a brown discharge but won't cause masculine skin characteristics.
There may be abdominal pain, and a dull ache in the lower back and thighs. An ovarian cyst can also cause pain after sexual intercourse. Confirming a diagnosis of an ovarian cyst is usually done with ultrasound.
- PID, or pelvic inflammatory disease. The condition is usually, although not absolutely always, associated with an infection. Symptoms may include an unpleasant-smelling brown discharge along with lower abdominal pain that begins just a few days after the last menstrual period. This pain may be dull and achy, or it may be crampy, constant, and bilaterial, occurring on both sides of the abdomen. There often is fever. There are sometimes flu-like symptoms. PID tends to occur during the first few months after a woman has an IUD inserted, or after chlamydia or gonorrhea infection. The condition can also be caused by herpesviruses, E. coli, or strep bacteria, among others. About 75 percent of women who have PID have a cervical discharge due to the infection. About 40 percent of women who have PID will bleed after sexual intercourse.
What should women do about brown discharges? If the source of the discharge is implantation bleeding, it will usually be about five more days before a home pregnancy test could detect conception. Even then, the results are not especially reliable. However, there won't be another menstrual period as would have been expected.
If the brown discharge is right before your period, right after your period, right after ovulation, or after sex, chances are it does not have any clinical significance. A woman can wear a panty liner and just make a mental note that the incident happened just in case further symptoms arise. However, any time a brown discharge smells funky or there is abdominal cramping, it's a good idea to contact a doctor for diagnosis and treatment. It's not a medical emergency, but it is the sort of thing that requires a doctor visit within one to two days.
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