Menopause is when a woman has no menstrual periods for at least a year. On average, women reach menopause just after 50 years of age, but this varies widely from person to person.
Experiencing discharge or brown spotting after menopause may not be a cause for concern. However, sometimes it can be a sign of an underlying medical condition. Regular checkups with a doctor are recommended to diagnose any unusual discharge.
In this article, learn about the possible causes of brown discharge after menopause, as well as about diagnosis and management.
The lining of the vagina walls gets thinner during menopause so that the vagina may become more sensitive to dryness and irritation.
Women may experience itching, burning, and off-colored discharge more regularly than before they entered the menopause.
Brown spotting after menopause is typically a sign of blood mixing into the discharge.
While fresh blood is red, it turns brown or black as it oxidizes and leaves the vagina.
The color may be lighter or mixed with other colors if the woman has an infection, such as a yeast infection.
Read on to learn about the potential causes of brown spotting after menopause.
1. Vaginal or endometrial atrophy
As hormone levels decrease during menopause, the vaginal lining or the uterine cells may become thinner. This thinning is called vaginal atrophy or endometrial atrophy.
Vaginal atrophy often causes the vagina to become drier, less flexible, and more susceptible to inflammation or infection than before menopause. Vaginal atrophy may lead to:
- brown spotting
- pain and inflammation
- bleeding after sex
The vagina may feel continuously uncomfortable, so a woman with these symptoms should speak to a doctor. A doctor may recommend hormone replacement therapy, as well as the use of water-soluble lubricants during sexual activity.
2. Endometrial hyperplasia
The endometrium may also get thicker after menopause. Similarly to vaginal or endometrial atrophy, this is often due to the body producing too much of the hormone estrogen and too little progesterone.
Thick endometrial tissue can cause bleeding and abnormal spotting.
Doctors may recommend hormone replacement therapy (HRT) to adjust the levels of the hormones and treat the issue. They may also consider surgery to remove thickened cells or perform a hysterectomy.
A vaginal infection can cause off-colored discharge that looks like spotting. It may also cause an unpleasant odor, itching, pain, and irritation in the area.
Factors that increase the risk of infections include:
A doctor will recommend antibiotics or antifungal medications to treat a vaginal infection.
4. Sexually transmitted infections (STIs)
Some STIs cause other symptoms in addition to spotting or brown discharge. Others, such as chlamydia, rarely cause symptoms, so it is essential to be tested for STIs regularly if a person has new sexual partners.
5. Strenuous exercise
Exercise is essential to keep the body in good shape, but it may also lead to brown spotting after menopause.
Some women regularly experience brown spotting after especially strenuous exercise, and this is usually not a cause for concern.
However, women who experience brown spotting after exercise for the first time should consult a doctor.
6. Hormone replacement therapy
One possible side effect of HRT is vaginal bleeding. This is because HRT may thicken the lining of the uterus.
The blood from this thickening will often appear as brown spotting in the underwear. Anyone who experiences frequent bleeding from HRT should speak to their doctor, as they may be able to adjust the treatment.
7. Other medications
In addition to HRT, other drugs may also cause vaginal bleeding, as a side effect. These include blood thinners and Tamoxifen, which is a drug used to treat or prevent breast cancer.
Doctors may recommend adjusting dosages or switching medications to relieve symptoms.
Polyps are growths attached to the uterus or cervix. They are usually noncancerous. Polyps may cause bleeding, brown spotting, and occasionally severe cramping.
Many women with polyps do not experience any symptoms, so regularly gynecological checkups are essential. Polyps are typically removed using surgery.
In some cases, sudden brown discharge can be a sign of a cancerous growth in the uterus. Vaginal bleeding is a common symptom of uterine cancer.
A cancerous growth may also cause other symptoms, including pelvic pain, pain during sexual activity, and pain during urination.
However, the symptoms of uterine cancer are similar to many other benign conditions, so it is vital to speak to a doctor and get a proper diagnosis.
To determine the cause of brown discharge after menopause, a doctor will ask about a person's medical history and any medications they are taking. They may also do a physical exam of the pelvis or take a swab to test for infections.
Other tests that may be recommended include:
- blood test
- pelvic ultrasound
- Pap smear
- dilation and curettage (D&C)
How a person manages brown discharge after menopause will vary depending on the cause.
It may help to wear sanitary pads or thin liners. Avoiding synthetic clothing in favor of more breathable materials, such as cotton, may keep a person feeling comfortable and can help prevent an infection. Loose-fitting clothing may also help avoid irritation.
The vagina may become more sensitive as the tissues thin during menopause. Soaps, laundry detergent, and lotions that contain fragrances or other chemicals may irritate and may need to be avoided.
While hygiene is important, douching is unnecessary. Douching should be avoided, as it may negatively affect the sensitive environment in the vagina.
Anyone experiencing dark red, black, or brown spotting for the first time after menopause should speak to a doctor.
While preventing every cause may not be possible, some causes of brown spotting after menopause may need treatment.