Bloody Discharge – meaning, causes and prevention

Bloody discharge is commonly a natural occurrence that may cause concern. It differs from standard vaginal discharge due to the presence of blood, which may indicate minor bleeding from the vagina, cervix, or uterus. It most commonly appears at different stages of the menstrual cycle—at the beginning, during, or at the end of the cycle.

What does bloody discharge look like?

Its colour may vary—from bright red to light pink or brown. Sometimes, it has a distinct metallic smell, reminiscent of copper. Although it is usually not a cause for concern, it is important to monitor any unusual symptoms, such as heavy bleeding, pain, or an unpleasant odour, as these may indicate an infection or other medical conditions requiring a doctor's consultation.

The type and colour of vaginal discharge can provide valuable insights into intimate health. While blood stained discharge is not always a cause for concern, its appearance and accompanying symptoms should be monitored. If you have any concerns or notice unusual changes, it’s best to consult a GP for proper assessment.

• Watery bloody discharge – May occur at the beginning or end of a period, but if it appears outside the cycle, it could be related to a reproductive tract infection, hormonal imbalance, or, in rare cases, cancerous changes.
• Brown bloody discharge – Often indicates old blood. It is normal at the end of menstruation, but if it occurs between cycles, it may suggest implantation bleeding, hormonal changes, or infections.
• Clear discharge with blood – Can result from ovulation and the rupture of an ovarian follicle, especially if it occurs mid-cycle. If it appears more frequently, it may indicate cervical irritation, such as after intense sexual activity.
• White discharge with blood – Often signals a vaginal infection, such as yeast infection or bacterial vaginosis (BV). If accompanied by an unpleasant odour, itching, or burning, a doctor's consultation is advised.
• Thick bloody discharge – May be associated with hormonal disorders, endometriosis, or ovarian cysts.
• Yellow discharge with blood – Can indicate a bacterial infection or a sexually transmitted disease (STD), such as gonorrhoea or chlamydia.

Bloody discharge, while it may cause concern, is a natural occurrence in many cases. Vaginal secretions play an important role in maintaining vaginal health by aiding in self-cleansing and protecting against infections. The appearance of bloody discharge around menstruation or during the first three months of hormonal contraception use, such as birth control pills, is completely normal. However, if it is accompanied by other concerning symptoms—such as pain, irregular bleeding, bleeding after sex (post-coital bleeding), an unpleasant odour, or an unusual consistency—it is advisable to consult a doctor.

Bloody discharge is most commonly associated with the menstrual cycle—it can occur just before, during, or after a period. In women using hormonal contraception, especially in the first 3 months of taking use, the body adapts to hormonal changes, which can also lead to spotting. It is important to remember that pregnancy, particularly in its early stages, may be accompanied by mild implantation bleeding. Sometimes, bloody discharge appears after intercourse, which may result from irritation of the vaginal walls or cervix. In menopausal women, hormonal fluctuations can cause vaginal dryness and slight bleeding. However, in some cases, bloody discharge may signal more serious issues, such as intimate infections or, in rare situations, gynaecological cancers and it is recommended to see a doctor if you have this symptom.

Bloody discharge and hormone imbalance

Hormonal imbalances are one of the most common causes of bloody discharge, particularly in teenagers and perimenopausal women. When abnormal uterine bleeding is hormone-related, doctors refer to it as dysfunctional uterine bleeding (DUB). This often results from natural changes in the body but may also be a side effect of hormonal contraception. Taking birth control pills can cause fluctuations in oestrogen and progesterone levels, sometimes leading to spotting. Similarly, stopping these medications can trigger temporary bloody discharge as the body adjusts to a new hormonal balance.

Bloody discharge and thyroid disease

Although small, the thyroid gland plays a crucial role in regulating many bodily processes, including the menstrual cycle. Both hyperthyroidism and hypothyroidism can lead to abnormal bleeding from the reproductive tract, including bloody discharge. Thyroid hormones influence oestrogen and progesterone levels, and their imbalance can cause irregular periods, heavy bleeding, or spotting between cycles. If any concerning symptoms appear, consulting a doctor should be the first step.

Bloody discharge and polycystic ovary syndrome

Polycystic ovary syndrome (PCOS) is one of the most common hormonal disorders in women of reproductive age, affecting the regularity of the menstrual cycle. In PCOS, the ovaries produce an increased amount of androgens—male sex hormones—which can disrupt ovulation and lead to irregular shedding of the uterine lining. As a result, bleeding may be light, irregular, or prolonged, and spotting may occur between cycles. If any concerning symptoms arise, it is essential to consult a doctor.

Bloody discharge, while it may cause concern, is a natural occurrence in many cases. Vaginal secretions play an important role in maintaining vaginal health by aiding in self-cleansing and protecting against infections. The appearance of bloody discharge around menstruation or during the first three months of hormonal contraception use, such as birth control pills, is completely normal. However, if it is accompanied by other concerning symptoms—such as pain, an unpleasant odour, or an unusual consistency—it is advisable to consult a doctor.

Bloody discharge and pregnancy

Spotting in your underwear mid-cycle may be a sign you’re pregnant. Approximately one third of women experience bloody discharge as a result of a fertilised egg implanting into the wall of the uterus. Implantation is approximately 11 days after ovulation, so bloody discharge just before or at expected time of period can be sign of pregnancy. You might want to consider buying a pregnancy test.

If you are already pregnant and are experiencing bloody discharge, always check with your doctor, especially if it’s thick bloody discharge and paired with cramping. Light vaginal bleeding during early pregnancy is common and is typically nothing to worry about but you should discuss it with your doctor.

It is important to remember that bloody spotting does not always indicate pregnancy. However, if it occurs at an unusual time in the cycle, taking a pregnancy test can help clarify any doubts.

Bloody discharge and sex

You may experience light bloody discharge after sex, which is natural in most cases and should not raise any concerns. It may result from minor irritation, vaginal dryness or intensity of the intercourse. However, if the bleeding is frequent, heavy or is accompanied by pain, seeing a doctor is advisable. If you have any concerns about this, please visit a healthcare professional.

Bloody discharge and menopause

Menopause is a natural stage in every woman's life that brings numerous hormonal changes, which can affect the regularity of the menstrual cycle. One of the first signs of approaching menopause is irregular bleeding and bloody discharge, which can occur before the period and even between menstruations. These are mainly due to a decrease in progesterone levels, the hormone responsible for regulating the cycle. Its deficiency causes the uterine lining to shed unevenly, which can lead to spotting before the expected period and prolonging its duration. If you are menopausal and develop bloody discharge, then please consult a healthcare professional.

Bloody vaginal discharge can be a symptom of various infections that irritate the delicate tissues of the reproductive organs and lead to abnormal bleeding. If you suspect it could be a sexually transmitted infection (STI), it’s important to see a GP for diagnosis and treatment:

• Chlamydia, which can cause bleeding after intercourse and spotting between periods. This infection often occurs without symptoms, so many women are unaware of its presence, increasing the risk of complications, including pelvic inflammatory disease.
• Vaginal candidiasis, also known as yeast infection. Although the typical symptom of this infection is a white, cottage-cheese-like discharge, intense itching can lead to irritation and micro-tears, causing bleeding.

Menstruation is a natural process where the uterine lining sheds, and menstrual blood mixes with vaginal discharge, leading to bloody discharge. This kind of discharge can appear at different stages of the cycle – as light spotting before the period, as a mixture of blood and mucus during menstruation, and toward the end, when the body clears the remnants of the shed endometrium.

Bloody discharge before period

Many women experience light spotting on their underwear a few days before their proper period starts. This can result from natural hormonal changes, but in some cases, it may signal disorders like corpus luteum insufficiency, which occurs due to insufficient progesterone production – a hormone crucial for cycle regulation and preparing the body for potential pregnancy.

Bloody discharge after period

At the very end of your menstrual cycle, you may experience brown bloody discharge. This is perfectly normal, and nothing to worry about. It is your body flushing itself out after menstruation. The blood appears brown because it’s not fresh blood. However, if bloody discharge persists long after the period ends or is accompanied by other concerning symptoms, it is worth consulting a doctor, who may recommend additional tests to determine its cause.

The first thing to reduce bloody discharge is to determine its cause, as the appropriate course of action depends on the underlying issue. If the discharge results from pelvic inflammatory conditions, antibiotics or antifungal medications may be necessary. In cases of irregular cycles, a doctor may recommend hormonal contraception to stabilise hormone levels and help prevent unexpected bleeding between periods. It is also important to maintain a healthy vaginal microbiome, so using products containing lactic acid bacteria can help support the natural protective barrier against infections. Regular testing for sexually transmitted infections, especially after changing partners, allows for early detection and treatment of infections that can cause spotting.