Experiencing brown discharge or spotting after menopause can sometimes be a sign of an underlying medical condition. Regular checkups with a doctor can help diagnose any unusual discharge.

Menopause is when a female has no menstrual periods for at least a year. On average, a person reaches menopause around 51 years, but this varies widely from person to person.

This article discusses possible causes of brown discharge after menopause, as well as diagnosis and management.

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In many cases, brown discharge after menopause is not a cause for concern.

It is typical for periods to change leading up to menopause. However, some people may experience bleeding or spotting even after menopause, which can include:

  • spotting that can range in color from brown to pink
  • unusual discharge
  • bleeding or spotting after sex
  • a heavier, period-like flow

Brown spotting after menopause is typically a sign of blood mixing into discharge. Or, blood can turn brown or black as it oxidizes and leaves the vagina.

A person should check any abnormal bleeding or spotting during menopause with a doctor, as it could signal an underlying health issue.

Read on to learn about the potential causes of brown spotting or irregular bleeding after menopause.

1. Vaginal or endometrial atrophy

As estrogen 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:

  • dryness
  • discharge
  • irritation
  • itchiness
  • pain
  • spotting
  • redness
  • bleeding after sex

The vagina may feel continuously uncomfortable, so a person with these symptoms should seek medical advice. A doctor may recommend hormone replacement therapy (HRT), as well as the use of water-soluble lubricants during sexual activity.

2. Endometrial hyperplasia

The endometrium may also become thicker after menopause. This is often due to the body producing too much of the hormone estrogen and too little progesterone.

Thick endometrial tissue can cause irregular bleeding or spotting during menopause.

Doctors may recommend HRT to adjust hormone levels and help treat the issue. They may also consider surgery to remove thickened cells or perform a hysterectomy.

3. Infection

Certain types of vaginal infections can cause unusually colored discharge that looks like spotting or bleeding after sex. These symptoms may also occur alongside an unpleasant odor, itching, pain, and irritation in the area.

Factors that increase the risk of infections include:

  • wearing wet clothes
  • wearing tight clothing
  • wearing nonbreathable undergarments

A doctor will recommend antibiotics or antifungal medications to treat a vaginal infection.

4. Sexually transmitted infections (STIs)

Some STIs, such as gonorrhea, may cause unusual discharge, spotting, or vaginal bleeding. Bleeding resulting from these STIs may be more prominent if they go untreated.

Some STIs also cause other symptoms. Others, such as chlamydia, rarely cause symptoms, so it is essential for people to be regularly tested for STIs if they have new sexual partners.

5. HRT

One possible side effect of HRT is vaginal bleeding or spotting. However, any irregular bleeding resolves within the first 6 months of treatment.

Anyone who experiences frequent or prolonged bleeding while taking HRT should speak with a doctor, as they may be able to adjust the treatment.

6. Other medications

In addition to HRT, other drugs may also cause vaginal spotting or bleeding as a side effect. These include blood thinners and certain medications to help treat mental health disorders.

Doctors may recommend adjusting dosages or switching drugs to relieve symptoms.

7. Polyps

Polyps are growths attached to the uterus or cervix. They are often noncancerous. In some cases, polyps can cause:

  • spotting
  • irregular bleeding
  • heavy bleeding
  • bleeding after sex

Many people with polyps do not experience any symptoms, so regular gynecological checkups are essential. Treatment can include watchful waiting, medications, or surgical removal.

8. Cancer

In some cases, vaginal bleeding or spotting after menopause can be a sign of a cancerous growth in the uterus, known as endometrial or uterine cancer.

A cancerous growth may also cause other symptoms, including:

  • pelvic pain
  • pain during sexual activity
  • pain with urination

Doctors usually treat this type of cancer with surgery. A person may also require chemotherapy or radiation therapy. When caught early, treatment is often successful, so it is vital for individuals to speak with a doctor about any symptoms.

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An ultrasound scan may be used to diagnose the cause of brown discharge after menopause.

To determine the cause of brown spotting or irregular discharge after menopause, a doctor will ask about a person’s medical history and any medications they are taking. They may also perform a physical exam of the pelvis or take a swab to test for infections.

Other tests a doctor may recommend include:

  • pelvic ultrasound
  • Pap smear
  • endometrial biopsy
  • hysteroscopy
  • dilation and curettage (D&C)

How a person manages brown discharge or unusual bleeding 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 an individual comfortable and 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 detergents, and lotions containing fragrances or other chemicals can irritate the area, and a person may need to avoid these products.

While hygiene is important, people should avoid douching, as it may negatively affect the sensitive environment in the vagina.

Anyone experiencing red, pink, or brown spotting or irregular bleeding after menopause should speak with a doctor. Understanding the cause can help determine the next steps and proper treatment.

Brown spotting or discharge after menopause may signal an underlying medical condition. There are various possible causes, including infections, a side effect of medications, and polyps. A person should contact a doctor for an assessment and possible treatment.