Generality
Brown leaks are a type of vaginal secretion that can occur for various reasons, at different times in a woman's life (fertile period, pregnancy, ovulation and menopause).
In some cases, brown losses do not depend on pathological causes, but on very stressful lifestyles, incorrect eating habits or transient hormonal imbalances. Other times, however, their appearance should be interpreted as a sign of an underlying health disorder. For this reason, in case of brown leakage from the vagina (or, more generally, of any unusual secretion) it is advisable to contact your gynecologist, who will be able to understand the causes and decide how to intervene.
What are
Brown losses: what are they?
Brown vaginal secretions are low blood loss, attributable to different causes, pathological or not. This symptom may indicate, in some cases, an unregulated lifestyle or a transient problem that can be corrected with some simple precautions. However, brown losses can also be the indicator of a pathological process or a dysfunction that needs to be investigated and tackled from a medical point of view.
In most cases, brown losses are intermenstrual, that is, they occur between one menstruation and another, but they can also precede the onset of the flow or persist after the conclusion of the same.
What does the brown color depend on?
The color of brown leaks is due to the presence of small amounts of blood, which take on a dark pigmentation : being of low intensity and remaining for some time in the vagina, the hemoglobin contained in the blood secretion undergoes an oxidation .
In most cases, brown losses have nothing to do with menstruation, but occur shortly or mid-cycle.
Causes and Risk Factors
The causes of brown losses are different and their meaning is not always pathological.
In most cases, these secretions are not such as to induce worries, but it is important not to underestimate their presence, especially if they are observed in repeated episodes.
Brown losses: what are they caused by?
Brown losses can occur in the presence of particular dysfunctional or organic conditions.
BROWN LOSSES OF DISFUNCTIONAL ORIGIN : they represent the most common causes, above all in fertile age. Dysfunctional brown losses are not caused by organic gynecological pathology, but by generally reversible imbalances and problems.
- Stress : the menstrual cycle is affected by periods of fatigue and intense psycho-physical stress . The brown losses can appear, in particular, due to the combined effect of cortisol (the hormone whose levels rise in particularly stressful moments) and of adrenaline, responsible for a sort of "state of alarm" for the organism. This condition is able to influence the hypothalamus, a structure of the central nervous system that regulates many physiological functions, including the activity of the ovaries and the production of progesterone, a hormone that stabilizes the menstrual cycle in women. During these episodes, you can see the appearance of brown leaks and menstruation late or ahead of the norm.
- Eating disorders : brown losses can be due to an unregulated dietary regime and problems related to nutrition, such as anorexia nervosa, bulimia and obesity . In fact, bad eating habits have a big impact on health and hormonal activity: even in these cases, menstruation can be irregular, disappear (secondary amenorrhea) or are replaced by brown leaks. In obese subjects, then, the abundant quantity of adipose tissue ends up behaving like an endocrine gland, which secretes a greater quantity of estrogen; these hormones are able to influence the proliferation of the internal mucosa of the uterus (endometrium), facilitating the flaking in an irregular and non-synchronous manner with the menstrual phase.
- Contraceptives : the use of contraceptives, such as the pill, the patch or the vaginal ring, can cause small brown losses between menstruation and the other. These episodes occur mainly in the early days, when the body has to get used to the hormonal variations that these contraceptive methods bring. The phenomenon generally ends in a few months and rarely tends to persist. Usually, these are not worrying losses, but it is always advisable to report these episodes to your gynecologist, to evaluate the possibility of modifying the dosage or choosing another contraceptive closer to your hormonal profile. Even the intrauterine spiral (IUD) can determine, especially a few months after insertion, the appearance of brown leaks; if these last over time and are associated with burns, they probably indicate a bad positioning of the device, which therefore must be removed.
ORGANIC CAUSES OF BROWN LEAKS: The pathologies that can cause the appearance of brown vaginal secretions are different and include endometrial polyps, cervical lesions and ovarian cysts.
- Ovarian cysts : brown losses occur mainly between one menstruation and another. Polycystic ovary syndrome can also manifest itself in this way.
- Fistula in the neck of the uterus : the so-called ectopia of the cervix (or cervical ectropion ) is generally congenital and does not represent, in itself, a pathological condition, but can be associated with some disorders. In the presence of a sore in the cervix, it is possible to find brown leaks, traces of blood after sexual intercourse and greater production of vaginal mucus.
- Uterine and polyp fibroids : they are benign tumors that originate in the uterus, at the cervical or endometrial level and, in addition to various other symptoms, can give rise to brown leaks.
- Pre-neoplastic and cancerous lesions : when referring to brown leaks, cancer is the major concern of every woman. In fact, this type of vaginal secretion can indicate, under certain circumstances, the presence of a neoplastic process. In this regard, we recall the importance of the Pap test that can be performed as part of a screening program for cervical cancer (every two to three years) or as a routine check during the gynecological examination. This examination shows early changes in the cervix (from the presence of tumor or precancerous cells to inflammation), offering the possibility of treating and resolving the lesions in their initial stage, before they degenerate in a neoplastic sense.
Other predisposing and / or aggravating factors
Several other factors can contribute to the appearance of brown leaks, including:
- Coagulopathies : brown losses may depend on coagulation dysfunctions, for example, related to a reduced number of platelets (thrombocytopenia);
- Pregnancy : brown losses can occur in the first weeks of gestation, due to the implantation of the ovum in the uterus, a physiological event that causes the rupture of some small blood vessels. Even in this case, however, the symptom should never be underestimated, as it could signal the presence of pathologies that could compromise the evolution of the same gestation. It should be noted that, in the event of a threat of abortion or spontaneous termination of pregnancy, blood loss is rather abundant and preceded and / or accompanied by severe pain in the lower quadrants of the abdomen. Repeated episodes of brown leakage may also be an indication of an ectopic pregnancy . Even in these cases, however, the cramping pains and the extent of the bleeding usually allow a correct diagnosis, right from the early stages.
- Ovulation : often, brown losses occur in the middle of the menstrual cycle, in conjunction with the ovulatory phase ; in this case, these are related to the physiological hormonal decline that precedes the rupture of the ovarian follicle . If recurrent or abnormal, brown losses during ovulation must induce you to undergo a gynecological examination: this manifestation could depend, in fact, on a malfunctioning of the ovaries (secondary, for example, to the polycystic ovary syndrome) or to an imbalance hormonal that induces an abnormal flaking of the endometrium.
Additional causes of brown losses are:
- Perimenopause ;
- Early menopause ;
- Vaginitis ;
- Bacterial vaginosis ;
- Vaginal dryness ;
- Endometriosis ;
- Inflammation of the cervix ( cervicitis );
- Sexually transmitted infections ;
- Slight abrasions of the vaginal wall after sexual intercourse ;
- Pelvic inflammatory disease (PID);
- Post-natal claws ;
- Foreign body held in the vagina (eg internal pad, pieces of toilet paper, etc.);
- Some medications, including anticoagulants (warfarin, dabigatran, apixaban or rivaroxaban), clopidogrel and tamoxifen;
- Thyroid dysfunction (hypoactive or overactive gland).
Rarely, serious medical conditions such as leukemia, chronic renal failure and cirrhosis of the liver may be involved in the appearance of brown spills.
Symptoms and Complications
Brown leaks are vaginal secretions consisting of low amounts of dark (oxidized) blood . This symptom may occur sporadically (associated with a single episode) or recurrent (that is, up to the resolution of the underlying pathology) depending on the cause.
These blood losses are not type of menstrual (that is, they do not have a bright red color and are not abundant) and can appear:
- In the intra-menstrual period, ie between one flow and another (often in conjunction with ovulation or immediately after);
- At the end of the menstrual flow;
- In the days immediately before menstruation;
- During or after sexual intercourse.
An important difference
- During menstruation, blood loss is bright red, because the flow is abundant and fast.
- In the case of brown leaks, however, the blood leakage is low and slow. This allows the oxidation of hemoglobin, which, depending on the cause, turns the color of blood from brown to dark brown . Generally, then, brown losses do not occur with a specific periodicity, but occur sporadically or abnormally (not regular).
Brown losses: which disorders can they be associated with?
Depending on the causes, brown leaks can be associated with other symptoms that affect the genital system or other body systems.
Among the most common disorders, which must always be taken into consideration, are:
- Frequent or painful urination;
- Pelvic pain;
- Vaginal itching;
- Excessive tiredness;
- Loss of appetite;
- Nausea and vomit;
- Mood swings;
- Breast tension.
Brown losses: when to worry
When they occur, brown losses must not alarm. However, it is always advisable to consult your gynecologist, especially if they are repeated frequently or for a continuous period, to exclude or identify any pathological conditions that are responsible for them.
Diagnosis
If the brown losses from the vagina should be repeated frequently or continue for a few days, it is advisable to investigate the causes with a careful medical evaluation, especially when they are associated with other disorders.
Brown losses: which exams are indicated?
Brown losses can depend on multiple factors, therefore it is essential to undergo a thorough clinical evaluation, supported by instrumental investigations and laboratory tests, to identify the exact cause and choose the most appropriate treatment.
Depending on the diagnostic hypothesis, the procedure may include:
- General gynecological examination (medical history and physical examination of the patient);
- Measurement of vaginal pH, in relation to possible vaginosis;
- Pelvic or transvaginal ultrasound to study the endometrium, uterus and ovaries;
- Pap smear, colposcopy and cervical biopsy ;
- Blood tests : dosage of sex and thyroid hormones, complete blood count, sideremia, coagulation factors, etc .;
- Diagnostic hysteroscopy to exclude the presence of polyps, hyperplasias or endometrial tumors.
The execution of more specific examinations is established in particular cases.
Treatment and Remedies
Treatment basically depends on the causes that led to the appearance of brown spills.
Brown losses: which therapies? Remedies and lifestyle
In many cases, it is not necessary to resort to special care, since it is a temporary event, destined to resolve spontaneously. If related to stress, for example, brown leaks can disappear after adequate rest that can restore the balance lost due to excessive psycho-physical fatigue. We should not forget, then, some simple rules that can induce the menstrual cycle to resume its natural rhythm, that is: eating well, sleeping regularly and practicing healthy and non-compulsive physical activity .
Other times, instead, brown losses depend on diseases that require medical treatments, generally of a pharmacological type, or specific surgical procedures for their solution.
