If you notice discharge during your period and see something other than red blood, try not to be alarmed. Blood is not always red during menstruation, and different blood colours can signify many things.
Generally, different blood colours are no cause for concern. However, they can occasionally be a sign of an underlying condition that requires medical treatment.
Read on to learn more about why menstrual blood can be red, pink, brown, grey, or orange, and when you should consider consulting a healthcare professional.
What Causes Brown Menstrual Bleeding?
Brown menstrual bleeding or discharge is typically older blood that has remained in the uterus for a longer period and has had time to oxidize.
This is most common at the beginning and end of your period, as the blood flows more slowly and, therefore, takes longer to exit your body. The longer it remains in the body, the more time it has to oxidize.
Periods with light bleeding can also result in brown menstrual bleeding or discharge.
In some cases, brown blood may be a sign of another condition:
Pregnancy
Brown blood or spotting can be a sign of implantation bleeding—a symptom of early pregnancy. This typically occurs approximately 6 to 10 days after ovulation.
Other signs and symptoms of implantation may include:
- mild pain
- swollen breasts
- nausea
- vomiting
Lochia
Lochia is the postpartum bleeding that occurs during the first 4 to 6 weeks after childbirth. This bleeding typically begins heavy and turns pink or brown around the fourth day, lasting 5 to 9 days.
Missed Miscarriage
A spontaneous miscarriage is typically associated with bright red bleeding; however, some people experience a “silent miscarriage”—sometimes referred to as a missed miscarriage.
A silent miscarriage occurs when the embryo or fetus passes away or stops developing, but the tissues are not immediately expelled from the uterus. Heavy bleeding does not occur; instead, there is only spotting or dark brown bleeding.
Perimenopause
Fluctuations in estrogen levels during perimenopause affect the lining of the uterus, which can impact the frequency, texture, and colour of bleeding.
This may manifest as brown menstrual blood at various points in the cycle. Generally, brown blood is nothing more than blood and tissue from the uterus that are being expelled.
Polycystic ovary syndrome (PCOS)
PCOS can prevent ovulation. When this happens, the uterine lining builds up but doesn’t shed properly, leading to infrequent or absent periods, often accompanied by brown spotting or vaginal discharge.
Other symptoms of PCOS may include:
- Excessive hair growth
- Weight gain
- Difficulty conceiving
- Acne
What causes menstrual blood to be dark red?
You may notice dark red menstrual blood when you get up in the morning or after you have been lying down for a while.
The deep red colour may be due to gravity, which causes blood to pool in the uterus for a time—though not long enough for it to oxidise and turn brown.
Like brown menstrual blood, dark red blood is also associated with lochia and the final stages of your menstrual period.
What causes menstrual blood to be bright red?
Bright red menstrual blood appears when fresh blood continues to flow. Some people experience bright red menstrual blood throughout their cycle, while others only notice it during the middle stages.
Bright red blood that appears between menstrual periods may be caused by:
- sexually transmitted infections (STIs), such as chlamydia and gonorrhoea
- other infections, such as bacterial vaginosis or yeast infections
- uterine polyps or fibroids
- hormonal fluctuations
- contraceptive methods
- miscarriage
- adenomyosis
It is important to consult a healthcare professional if you experience bleeding or spotting between menstrual periods, as this may require medical treatment.
What causes menstrual blood to be pink?
Generally, pink menstrual blood is simply blood mixed with cervical fluid and other vaginal secretions, especially if this occurs at the beginning or end of your period. You may also notice pink menstrual blood on days when your flow is lighter.
After childbirth, lochia (postpartum bleeding) may be pink or brown.
Other possible causes of light bleeding, spotting, or the presence of pink blood between your regular menstrual periods include:
- low estrogen levels
- ovulation
- miscarriage
What causes orange-colored menstrual bleeding?
Orange-colored discharge can occur when blood mixes with cervical fluid, which is usually normal.
However, orange menstrual bleeding may also be associated with implantation bleeding or an infection, such as a sexually transmitted infection (STI).
What causes gray-colored menstrual bleeding?
Menstrual bleeding should not be grey or a similar light colour. If it is, it is important to consult a healthcare professional, as it may require medical treatment.
Gray-colored menstrual blood or discharge can be a symptom of an infection, such as bacterial vaginosis. Other symptoms of a vaginal infection may include:
- itching
- foul-smelling discharge
- fever
- pelvic pain
Grey discharge can also be a sign of a miscarriage. Tissue expelled from the vagina may be grey, pink, or white, and may have a stringy texture.
What Causes Black Blood During Menstruation?
Seeing black blood during menstruation can be alarming. However, it is usually old blood that has remained in the uterus for an extended period and has oxidised, first turning dark red, then brown, and finally black. This is more likely to occur on days when the flow is light—either at the beginning or at the end of the menstrual period.
In some cases, black discharge may be an indication that a foreign object has become lodged in the vagina, such as:
- tampons
- sex toys
- menstrual cups
- contraceptive methods, such as diaphragms and cervical caps
- condoms
Other possible causes of black discharge may include:
- pelvic inflammatory disease (PID)
- sexually transmitted infections (STIs)
- missed miscarriage
- lochia
Over time, this can irritate the lining of the vagina and lead to an infection. In addition to black discharge, you may notice an unpleasant odour, itching or a rash in the vagina and vulva, as well as fever and pelvic pain.
Consult a healthcare professional immediately if you suspect that an object is stuck inside your vagina or if you experience symptoms of an infection.
Frequently Asked Questions
Is it normal for menstrual blood to have different colours at the beginning and end of a period?
Yes! Generally, menstrual blood flows more slowly at the beginning and end of a period, so it may appear pink or brown. Toward the middle of the cycle, when the flow is heavier, the blood is typically bright red.
However, the colour may vary from one month to another or at different times.
What does it mean if menstrual blood is watery or contains many clots?
Watery menstrual blood is most likely simply fresh blood flowing rapidly from the uterus.
Clots in menstrual blood often form as the uterus sheds its inner lining. It can also happen during days of heavier bleeding.
However, size matters. If blood clots exceed 2.5 centimetres in diameter—or are the size of a quarter—consider consulting a healthcare professional. Excessive bleeding can lead to anaemia and cause symptoms such as fatigue and shortness of breath.
When to Consult a Healthcare Professional
A healthy menstrual period can appear in a variety of colours and textures; however, consider consulting a healthcare professional—such as a primary care physician or an obstetrician-gynaecologist (OB-GYN)—if you experience any of the following:
- Irregular cycles that vary considerably in duration from one month to another
- cycles lasting less than 24 days or more than 38 days
- absence of menstruation for 3 months or more
- bleeding accompanied by other symptoms, such as severe pain, vaginal discharge, pain during urination, or itching
- bleeding between menstrual periods
- You have already gone through menopause and have begun bleeding again
- You are pregnant and begin experiencing spotting or bleeding
- gray-colored discharge, which could indicate a miscarriage or an infection
In Summary
The colour and texture of your menstrual blood can vary from one cycle to another—or even from one day to the next—especially during certain stages of life, such as when you have just started menstruating or are approaching menopause.
Most changes in the colour of your menstrual flow are not a cause for major concern; however, it is important to pay attention to them, as well as to any other symptoms you may experience. Do not hesitate to consult a healthcare professional if you have any concerns regarding your period.