Is brown menstruation normal? Gynecologist explains possible causes

Not every woman realizes it, but it is normal for menstruation to have fluctuations in volume and color: ranging from a scant amount at the end and beginning of the flow – similar to “coffee grounds” – to more intense and consistent bleeding, sometimes accompanied by clots.

Such changes in menstrual flow can sometimes worry a woman who is always attentive to her intimate health. Many question, for example, if a brown period can be a sign of a problem or if it can be related to pregnancy. Precisely for this reason, before anything else, it is necessary to be aware of the normal variations to menstruation, to understand from what moment it may be necessary to seek medical advice.

Patrícia de Rossi, gynecologist at the Conjunto Hospitalar do Mandaqui, in São Paulo, explains that the menstrual cycle usually lasts from 25 to 35 days, with an average of 28 to 30 days. “It is very common that there are changes from one month to the next, so we consider it ‘regular’ when there is a variation of up to 3 days, more or less, between periods. The normal duration of the flow is 2 to 7 days (with an average of 3 to 5 days),” she says.

It is also important to remember that the use of medications such as the combined contraceptive pill can reduce the duration and volume of the flow, as highlighted by the gynecologist.

However, according to Patricia, some changes do deserve attention. “If the menstrual flow is heavy with, for example, volume that fills a regular tampon in less than 2 hours, or with clots larger than 2.5 cm, it is possible that there is a hormonal or uterine cause that deserves to be investigated”, she explains. .

“If this happens after a missed period, it could also indicate a problem related to a pregnancy, such as a threatened miscarriage. In this case, a medical evaluation is recommended to define the diagnosis”, adds the doctor.

Patricia also explains that if the menstrual change persists for a few months or causes other symptoms, such as pain, weakness or tiredness, a consultation with a gynecologist is necessary to investigate the problem, including tests for anemia.

What is brown menstruation? Is it a sign of illness?

If the brown discoloration of menstrual flow is your concern, don’t worry, it’s probably nothing serious.

“Dark menstrual bleeding, similar to ‘coffee grounds’, is characteristic of the beginning and, mainly, of the end of the menstrual flow. This is a normal aspect for this phase, in which the blood that took longer to be expelled from the uterus undergoes chemical transformations that lead to this change in color”, explains Patrícia.

“Some women still have this type of bleeding between periods, when it’s called ‘spotting’ or spotting. In most cases, this is not a sign of any disease, but it commonly occurs in women who are using a progestin-containing contraceptive method, such as the levonorgestrel intrauterine device, quarterly medroxyprogesterone injectable, subcutaneous contraceptive implant, or progestogen-only pill (desogestrel )”, highlights the doctor.

As Patricia emphasizes, unless the woman is pregnant or after menopause, this type of bleeding should not cause great concern. “But when in doubt, medical evaluation is recommended for clarification and guidance”, she says.

5 possible causes of brown menstruation

Patricia points out below the main situations that can cause brown menstruation:

1. Normal menstrual variation

Patrícia recalls that dark menstrual bleeding (similar to “coffee grounds”) is characteristic of the beginning and end of the menstrual flow, thus being normal: since the blood took longer to be expelled from the uterus, undergoing chemical transformations that lead to this change in color.

2. Use of contraceptive method

The gynecologist points out that some women can experience a type of brown bleeding between periods, called “spotting” or spotting. In most cases, it happens in women who are using a progestin-containing contraceptive method, such as a levonorgestrel intrauterine device, a quarterly medroxyprogesterone injectable, a subcutaneous contraceptive implant, or a progestogen-only pill (desogestrel).

3. pregnancy

Patricia explains that it is interesting to make sure there is no pregnancy. “Because, in this case, brown menstruation can be treated in several situations, including some serious ones, such as miscarriage and tubal pregnancy”, she says.

4. Injuries to the cervix

It is worth investigating if this is not the case. “Injuries to the cervix can be diagnosed through speculum examination in the gynecological consultation, supplemented by oncotic cytology (preventive, Pap smear) and, in some cases, colposcopy (examination of the cervix with a magnifying lens after application of acid acetic acid) with or without biopsy (removal of a fragment of the region to be analyzed under a microscope)”, explains Patrícia.

5. Problem in the endometrium

In post-menopause, that is, after a year without menstruating and without using hormones, brown menstruation can represent a problem in the endometrium (inner layer of the uterus). “We usually do tests to get information about endometrial thickness and other causes of bleeding at this age (endometrial polyp or atrophy, for example). Another test that can clarify these cases is hysteroscopy (visualization of the inside of the uterus with a microcamera)”, explains Patrícia.

Can brown period be a sign of pregnancy?

Yes, answers Patricia. “Mostly in women who are not using contraception or using it incorrectly/eventually,” she says. So, if this is the case for her, don’t rule out the possibility of pregnancy.

But it’s not worth despairing and/or jumping to conclusions. investigate. “The diagnosis is made by the urinary hCG test or, more precisely, by the beta-hCG in the blood”, recalls the gynecologist.

If it occurs frequently, should the woman have any tests?

Patrícia explains that an annual routine gynecological consultation is recommended for clarification, “except in the cases mentioned or if the woman feels uncomfortable with the symptom”.

“If this menstrual pattern is a consequence of the use of any medication or contraceptive method, the woman must decide with her doctor whether to continue using it or not”, adds the gynecologist.

Now you know: brown period is not always cause for concern. It may just represent a normal change in your menstrual flow.

In some cases, it can be related to a health problem and even pregnancy. But it’s no use getting desperate and/or jumping to conclusions. The ideal is, in case of doubt, to consult your gynecologist, who, if deemed necessary, will investigate the case, evaluating other possible symptoms (if any) and/or requesting tests.

In addition, regardless of symptoms, the annual routine consultation with the gynecologist is essential, and it is what will prevent any type of problem and / or unnecessary worries about your health.

The information contained on this page is for informational purposes only. They do not replace the advice and follow-up of doctors, nutritionists, psychologists, physical education professionals and other specialists.