How to stop spotting

Is It Normal to Have Brown Discharge on Birth Control Pills

Birth control pills are the most effective way to prevent unplanned pregnancies. Birth control pills are hormonal pills that stop the body from ovulating by thickening the cervical mucus to prevent sperm from getting through and changing the uterine lining to prevent implantation of a fertilised egg. The birth control pills, however, have a number of side effects. One of the common side effects that women often complain of is brown vaginal discharge. This article talks about brown discharge, how to prevent it, and when you should consult a doctor.

Is it a Miscarriage?

Bright red spotting or bleeding in the first trimester can indicate a miscarriage. It is estimated that half of all pregnancies end in miscarriage, though often it’s so early that it isn’t noticeable. If an ultrasound shows a normal heartbeat between seven and 11 weeks, then there’s more than a 90% chance of not miscarrying, according to a study in the U.S. National Library of Medicine.

Bleeding during pregnancy can be classified either as a threatened miscarriage or an inevitable miscarriage. A threatened miscarriage will present with spotting or bleeding and often abdominal pain, but the cervix is still closed upon examination. An inevitable miscarriage however means that the cervix is dilated, bleeding is heavy and a miscarriage is almost certain to occur. Someone who is may be miscarrying could experience some or all of the following symptoms during pregnancy.

Symptoms of Miscarriage

  • White/pink mucus discharge
  • Brown or bright red bleeding
  • Abdominal cramping and pain
  • Blood clots
  • Lower backache

How to Prevent a Miscarriage

While you can’t prevent a miscarriage if your body isn’t meant to carry the embryo, there are ways to prevent a full miscarriage if you suspect you may be having a threatened miscarriage. Note that if the cervix is already dilated and the bleeding is heavy, then it’s likely an imminent miscarriage and probably can’t be stopped. If you suspect a miscarriage, contact your midwife or doctor right away. Your health care provider will be able to examine you and let you know what’s going on.

In a threatened miscarriage, the cervix is still closed, so there’s still a chance that the baby will stay put for a while. Your midwife or doctor will be able to give you guidance, but the following tips can be helpful at preventing a threatened miscarriage from becoming an imminent miscarriage. The most important thing is to relax and reduce stress.

  • Put your feet up and relax
  • Don’t lift anything over 10 pounds
  • Bed rest
  • Stay calm
  • Try forest bathing
  • Repeat positive affirmations. The brain is a powerful tool!
  • Take magnesium to relax, or use a topical magnesium oil or lotion
  • Recline in the bathtub with some soothing Epsom salts (which are magnesium)
  • Get help if needed. Have family or friends help out with household tasks or taking care of the kids.

Other Reasons for Spotting During Pregnancy

There are many other reasons other than miscarriage for spotting during pregnancy that could cause red or brown spotting. Some possible causes are:

Subchorionic Hemorrhage

This condition is when blood accumulates in the folds of the outer fetal membrane next to the placenta or between the uterus and placenta. Usually these resolve themselves, but sometimes it can increase the risk for preterm labor or other complications. A subchorionic hemorrhage causes light to heavy spotting and can be brown, dark blood possibly accompanied by blood clots. The blood clots are either absorbed by the body or expelled from the vagina. Even though this issue may not be serious, it still requires prompt medical attention.

STDs and Infections

Most providers will routinely test for the sexually transmitted diseases chlamydia and gonorrhea during pregnancy, as these can cause health issues for the baby. Group B Strep bacteria is also routinely screened for, as it can cause bladder or uterine infections or complications in newborns. Both STDs and infections can irritate the cervix and cause spotting.

The blood is sometimes accompanied by mucosal discharge. If you have a fever, painful urination, nausea or vomiting along with spotting, be sure to contact your health provider right away. This could indicate a urinary tract infection or other illness, and needs addressed promptly.

Cervical Polyp or Fibroid

Fibroids are growths that can occur in the uterine lining. If the placenta embeds itself in a uterine fibroid, it can cause some bleeding. Bleeding can also occur if there is a polyp on the cervix. A polyp is an abnormal growth that often occurs as a result of elevated estrogen levels during pregnancy. Combined with an increased number of blood vessels in the cervix, the cervix is more likely to bleed if there is polyp present. Note that polyps are usually benign are not cause for concern. But any continual spotting or bleeding should be brought up to your health care provider just to be safe.

Ectopic Pregnancy

An ectopic pregnancy is when the embryo is lodged outside of the uterus, typically in a fallopian tube. This is sometimes called a tubal pregnancy, which can rupture the fallopian tube as the embryo grows. According to the American Pregnancy Association, ectopic pregnancy occurs in about 1 of 50 pregnancies and almost always results in the loss of the pregnancy. The blood can range from spotting to bleeding, and is usually brown or red.

Ectopic pregnancy is a serious complication and should be addressed immediately as it can also result in severe health complications for the mother. Be sure to tell your health care provider right away if you experience any of the following symptoms along with the spotting or bleeding:

  • Pain in the shoulders
  • Pain in the pelvis or abdominal muscles
  • Severe sharp pain on one side of the lower abdomen
  • Rectal pressure
  • Lightheadedness or fainting
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Spotting or Bleeding During the Third Trimester

Once you are in your third trimester, spotting or bleeding could indicate the beginnings of labor, so it’s important to pay attention to your body and contact your health care provider immediately if you experience any pre-labor symptoms or unknown bleeding. Some possible causes for bleeding the the third trimester include the loss of your mucus plus and what’s known as the “bloody show,” which isn’t nearly as messy as it sounds.

Losing the Mucus Plug

As your body prepares for your baby’s arrival, it will usually include the loss of your mucus plug. The mucus plug can vary in color from clear to white, or even be green, pink or brown. However, it is often clear with streaks of pink or brown. You will usually lose your mucus plug sometime during or after your 37th week of pregnancy, as it is usually a sign that your cervix is softening and/or dilating in preparation for labor. This may be accompanied by the bloody show.

Bloody Show

This event occurs at the tail end of pregnancy and is the result of tiny capillaries bursting in the cervix as it prepares for labor. First time moms usually have bloody show a few days before labor begins, while others usually don’t experience it until the cervix is dilating for active labor. The bloody show is a minimal amount of discharge that can range from brown, to pink, to the most common, bright red. It’s a sign that baby is on the way soon and there nothing to worry about. Bloody show may be accompanied by the loss of the mucus plug before active labor, or maybe not.

Premature Labor

Premature labor could also be a reason for spotting or bleeding in your third trimester. Premature labor is defined by the CDC as labor that starts before 37 weeks. But it’s important to understand the differences in contractions and symptoms to know whether your body is ready to have a baby.

Braxton Hicks contractions can often be mistaken for premature labor. However, Braxton Hicks contractions are small, practice contractions your body makes as it prepares for actual labor and they usually don’t involve any other symptoms.

Prodromal labor on the other hand feels like real contractions that even increase in frequency and intensity, but it also doesn’t result in baby’s appearance. Read more about Braxton Hicks contractions and prodromal labor symptoms.

Unlike Braxton Hicks contractions or prodromal labor, premature labor does result in the birth of the baby. Let your midwife or doctor know right away if you’re having the following symptoms, as premature labor requires prompt care for you and baby:

  • Vaginal discharge
  • Cervical dilation (you may or may not be able to feel that this has happened)
  • Pelvic pressure as baby descends or pushes down
  • Abdominal and/or uterine cramps
  • Lower back pain that’s dull
  • Loss of mucus plug or bloody show

What Will Your Provider Do if There’s Spotting or Bleeding?

If the spotting is minimal and your symptoms point to an issue that isn’t serious, your midwife or doctor may choose to wait it out. Frequent spotting however can be due to a hormonal imbalance, and in this case your provider may check your HcG and progesterone hormone levels. It really depends on the specific discharge and symptoms you’re experiencing, but your provider may also do one or more of the following:

  • Perform a vaginal exam to check the cervix and vagina
  • Perform an ultrasound to monitor the baby
  • Use a doppler or fetoscope to check the baby’s heartbeat
  • Recommend abstaining from sex
  • Check for a UTI or other infection

Causes of Brown Discharge while on Birth Control Pills

Birth control pills do cause a brown discharge, but there are several other factors that could lead to a brown discharge in women. Listed below are the factors that could result in brown discharge when on birth control pills:

Most of the time, the brown discharge is nothing but old blood. After your period, the body may expel the remnants of the uterine lining that are still left inside. The iron content in the old blood gets oxygenated to make it appear brown.

2. Spotting

In the initial 6 months of taking birth control pills, your body tries to adjust to the hormones in the pills and a consequence of this is spotting or breakthrough bleeding that is brown in colour. The pills affect the amounts of Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) in the body. This makes the uterine lining thinner, and the excess endometrial tissue (inner lining of the uterus) is shed and is expelled as brown discharge.

In some cases, the brown discharge is basically spotting which is a result of very low levels of hormones present in the birth control pills. This is risky as it reduces the effectiveness of the pills. If this is the reason, ask your doctor if the dosage needs to be increased.

4. Missed Pills

Birth control pills work effectively only if they are taken at the same time each day. If you miss taking 1 or 2 pills, your body’s hormonal balance gets upset and results in brown discharge. This is because the endometrium starts thinning again.

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The pills usually contain the hormones oestrogen and progestin in varying concentrations. Brown discharge could occur as a side effect if you are sensitive to a specific birth control pill.

6. Fibroids

Fibroids are non-cancerous growth inside the uterus. These can cause spotting in the form of brown discharge. This can be diagnosed by your doctor using an ultrasound test. Uncommonly heavy periods ending with brown discharge are also a cause for concern as this may be due to uterine fibroids or ovarian cysts. Consult a doctor if you are experiencing such symptoms.

Uterine fibroids

7. Implantation

If you are on birth control pills but still ovulating, you may get pregnant. In this case, the cause of brown discharge is implantation bleeding. When a fertilised egg implants itself into the uterine lining, a tiny amount of blood will come out. This spotting may look like brown discharge. If you suspect this, take an early detection home pregnancy test to confirm. Stop your birth control if you are pregnant and call your doctor right away.

8. Ovulation

Birth control pills suppress ovulation. However, if you miss a dose or the dosage itself is too low, you may ovulate. There is usually brown discharge when you ovulate. This happens 10-14 days prior to your next period. For this, you may need to use a backup method of birth control and speak to your doctor immediately.

9. Infections

Sometimes, brown discharge can be a sign of a vaginal infection or a sexually transmitted infection (STI). It could be bacterial vaginosis, gonorrhoea, or chlamydia. If you have redness, pain, itching, fishy odour, or discomfort in the vaginal area along with brown discharge, consult your doctor immediately.

10. Pap Smear

The pap smear is a cervical smear test performed on women to check for cervical cancer. It involves using a speculum to open the vagina and scraping tissue from the outer opening of the cervix to examine it for cancerous or pre-cancerous cells. In some women, the scraping can cause light bleeding for a few days. This bleeding can appear as a brown discharge.

Tips to Deal with Brown Discharge

Brown discharge may be due to various reasons. Here are a few tips to deal with brown discharge:

  • Use Pads: Use pads or panty liners every day for the first few months after you start taking birth control pills. Carry extra pads or liners with you in case the discharge is heavy and you need a fresh pad.A sanitary pad
  • Backup Contraception: Use a backup method of contraception for a while after you start taking the pills. This is to make absolutely sure that the dosage is correct for you and the pills are working. Low doses may cause brown discharge, and you will be at the risk of getting pregnant if you do not use a backup like condoms or spermicide.
  • Consult a Doctor: If the brown discharge continues and does not disappear on its own, consult a doctor immediately.

How to Prevent Brown Discharge while on Birth Control Pills

Here are some ways  to prevent brown discharge while on birth control pills:

  • Consume the pills at the same time every day. If you take it much later than the previous day, your hormonal balance will be disturbed and this may cause brown discharge.
  • Do not miss taking the pills. If you miss a dose, consult your doctor’s and ask him what should be done for it. Missing more than 1 dose continuously can make the birth control pills ineffective and can also cause brown discharge.
  • Do not take over-the-counter birth control pills. It is best to take the birth control pills that are specifically prescribed to you by your doctor which contain the right dosage of hormones for your body. If you take pills that are not prescribed for you, they will be ineffective against pregnancy and result in brown discharge.
  • Drink plenty of water. Staying hydrated can help in flushing out toxins from the body and prevent brown discharge.
  • Talk to your doctor; he will suggest you the birth control pills that suit your body. If the pills are not strong enough, your periods may not be regulated. As a result, you will have irregular menstruation and brown discharge.

When is Brown Discharge a Serious Problem

Although brown vaginal discharge is a common side-effect of birth control pills, there are some instances when the discharge could indicate a serious health problem. You should be seriously concerned if you have a brown discharge in the following circumstances:

  • Foul or Fishy Odour: If there is a foul odour emanating from the vagina along with the discharge, you should talk to a doctor soon. This is usually a sign of infection and may require treatment with antibiotics.
  • Redness in the Vaginal Area: Redness in the vagina is again a sign of infection and should not be taken lightly.
  • Swelling and Soreness: Pain and swelling usually occur when there is an infection in the vaginal area. Itching in the vaginal area along with brown discharge should also not be ignored.
  • Pain or Cramps in the Abdomen: Having brown discharge with abdominal pains is also an indicator of vaginal infections like bacterial vaginosis, trichomoniasis, or chlamydia.
  • Fever Higher Than 100.4°F: See a doctor immediately if you have a high fever along with brown discharge. This could mean that a vaginal infection is progressing and needs immediate treatment.
  • Symptoms Similar to Flu: If you feel fatigued, lethargic, and have body aches along with a fever and brown discharge, go to the hospital immediately as this may be due to a serious infection.
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When you start taking birth control pills, your body makes adjustments to deal with the extra hormones that the pills contain. Not all women will experience the same side-effects. Some women may have light spotting, some may get their period twice in one cycle, and some may have brown discharge. This is normal; after 6 months, your body gets used to the pills, and spotting or brown discharge will automatically reduce or disappear. However, consult your doctor in case the brown discharge doesn’t clear on its own within a few days.

Also Read: Side-Effects of Birth Control Pills

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“Why am I spotting” reason: You’re stressed.

The gynecologist says: “Stress plays a complex role in spotting and cycle changes,” says Costescu. “Likely the increase in cortisol affects the body’s signaling system and the change in hormones causes spotting to occur.”

Why am I spotting polyps illustrationillustration credit: shutterstock

The gynecologist says: Now as much as I’m told spotting can be considered “normal,” it can also be a cause for concern. That’s why my doctor had me do a Pap, an ultrasound and blood tests. “If you have significant or bothersome spotting, a trip to the doctor is warranted,” says Costescu. “Polyps are small growths on the cervix that can bleed on contact. They are benign but can be removed if bothersome,” he says. “Ectropion is a normal condition where the glandular cells – the ones that look like the lining of the uterus – are prominent on the cervix. This can bleed easily if poked. […] In some [medical] centres, liquid nitrogen can be used to freeze the ectropion to prevent further bleeding.”

Why am I spotting hormones illustrationillustration credit: shutterstock

“Why am I spotting” reason: Your levels of progesterone and estrogen are off balance.

The gynecologist says: “Spotting can be a sign that hormone levels are off, but in most cases,” says Costescu. “It is normal for a small amount of spotting around ovulation – two weeks before a period is due – related to hormone changes. Women who find spotting to be a nuisance can talk to their doctor about options. The most common option is to try a birth control pill, which is progestin-dominant and will help stabilize the lining.” He also adds: “Numerous studies have looked at supplements that can help control [hormone-related] spotting. Unfortunately, while small studies show promise, most large scale studies do not show benefit for Vitamin B supplementation, Vitamin C or Iron.

Why am I spotting birth control illustrationillustration credit: shutterstock

The gynecologist says: Some women who take The Pill might notice spotting, because of the dosage of estrogen. “In any case where a woman experiences spotting on the pill,” says Costescu, “an IUD, either copper or hormonal, such as a Mirena, Kyleena of Jaydess, is a reasonable next option.”

Why am I spotting pregnancy test illustrationillustration credit: shutterstock

The gynecologist says: “Some women may experience an ‘implantation bleed’ once a pregnancy has taken hold,” says Costescu. “Any irregular period or bleeding warrants a pregnancy test. Implantation bleeds are also a common culprit when a woman finds out she is further along in her pregnancy than expected – that bleed can be confused for a period.”

Why am I spotting ovaries illustrationillustration credit: shutterstock

The gynecologist says:Menopause is a time of transition, which can start five to 10 years prior to periods stopping,” says Costescu. “Some women experience spotting because they aren’t releasing an egg each month, and so the body isn’t going to have a normal period. Other women, as their hormone levels drop, may experience very light flow or spotting, as the lining of the uterus becomes dormant.” But if you’re thinking it might be a very early menopause, don’t worry about that. “In a healthy young woman, spotting is not a warning sign of menopause,” says Costescu.

why am I spotting, when to talk to our doctorillustration credit: shutterstock

The gynecologist says: Instead of being frustrated, talk to your doctor. “If spotting is rare, and there are no red flags, then a visit to the doctor is probably not necessary, says Costescu. “The occasional irregular period or episode of spotting is normal. But there are a few conditions associated with spotting that your doctor will want to rule out if you go.” And he adds that we need look for patterns, like when it happens and at what point in the cycle it occurs. And make note if you changed sexual partners, are taking new medication, or anything else in your lifestyle that is different and might affect what’s going on down there. At the office, our favourite cycle trackers include: Clue, P Tracker and Pink Pad.

Costescu sent me these top five things to make note of if you’re spotting.

  1. In most cases, the occasional episode of spotting is nothing to worry about.
  2. It is normal for some women to experience spotting at the beginning or tail end of a period.
  3. Spotting is very common in the first few months of use of any birth control, including pills and IUDs. Spotting when on birth control does not mean it’s not working. You can be reassured that you will still get protection from your contraception.
  4. Beware of  spotting that can be a warning sign for the following: An STD (you notice spotting around the start of a new sexual relationship), cervical cancer (spotting comes with pain, particularly with intercourse or if you have not had a Pap test), an infection (accompanied with fever or discharge), or pregnancy, miscarriage or ectopic pregnancy (around when your period should come).
  5. Smoking increases the rate of spotting, so if the thousands of other reasons to not smoke are not enough, add this one to the list.

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