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Date of last update: 10/14/2017.

Forum Name: Gynecology

Question: Brown discharge and bleeding


 precioushalo87 - Sat Oct 15, 2005 6:01 pm

Hello,
I have been haveing a brown discharge with some blood for about 2 weeks. it started when i was supposed to start my period. But i have not yet started. I am not sexualy active... so i don't think pregnancy is the answer. Could you please help me?
Thank you.
 Dr. Tamer Fouad - Sun Jan 01, 2006 2:09 pm

User avatar Hello,
Brown discharge usually indicates "old blood".
This may happen right after periods, and is just "cleaning out" your vagina.This may be caused from the uterus not completely shedding the products of menstruation, minor vaginal/cervical trauma during intercourse, hormonal imbalances. This is also occasionally experienced by women on oral contraceptives.

It may also occur when you are ovulating/mid-cycle.

Sometimes early in pregnancy you may have spotting or a brownish discharge at the time your period would normally come. If you have spotting at the time of your normal period rather than your usual amount of flow, and you have had sex without using birth control, you should check a pregnancy test.

If you have ruled out pregnancy and are not taking any medicines that are known to cause abnormal uterine bleeding and not known to have any systemic diseases such as liver cirrhosis/ coagulation defects, then further examination and testing will be directed at exclusion of abnormalities of the reproductive tract such as benign pelvic lesions (adenomyosis, endometriosis, cervical or endometrial polyps, submucosal fibroids) as well as infection, malignancy (if obese/ other risk factors are present) and trauma.
Once all these causes are excluded it can be presumed that you have dysfunctional uterine bleeding. Dysfunctional uterine bleeding is a diagnosis of exclusion. In the vast majority of cases, it is secondary to anovulation (lack of ovulation). If you do not experience cramps or other premenstrual symptoms this could be a manifestation of anovulation.

Some common causes of hypothalamic anovulation are weight loss or gain, eating disorders, stress, chronic illness, and excessive exercise. Women with chronic anovulation that is not attributable to any of these causes are considered to have idiopathic chronic anovulation.[1]

Anovulatory bleeding can be thought of as estrogen breakthrough bleeding. This type of bleeding is related to the levels of estrogen stimulating the endometrium. For example, high levels of estrogen for prolonged periods result in amenorrhea followed by acute intermittent heavy bleeding, and continually low levels of estrogen availability result in intermittent spotting.[2]

References:
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1. Oreil KA, Schrager S. Abnormal uterine bleeding. Am Fam Physician 1999;60(5):1371-82.
2. Speroff L, Glass RH, Kase NG, eds. Dysfunctional uterine bleeding. In: Clinical gynecologic endocrinology and infertility. 5th ed. Baltimore: Williams & Wilkins, 1994:575-93.

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