Talking About SRH: It’s Not Just One Conversation

Understanding your period is an important prerequisite for being able to identify any abnormalities and possible causes for concern. A sudden change in your period blood color can cause immense panic but reading up on these changes beforehand, can help you in knowing what to do in case it ever happens to you.

Period blood ranges from red, pink, orange, brown to black. Colors can change throughout your cycle, depending on the flow, variating between shades of red. Colors can change from cycle to cycle as well, due to factors such as: how much uterine lining is involved, hormonal changes, dietary changes, age and lifestyle.

However, a sudden change in color, especially an unfamiliar shade with accompanying symptoms, does require a trip to the doctor.

Here are the possible colors and what they indicate:

  • Brown: old blood, that has travelled through the reproductive tract slowly and become oxidized, changes from red to brown. This old blood is often cleaned out at the beginning of the next cycle. It is associated with:
  • The start or end of your period: During a slow flow, blood takes longer to exit your reproductive tract, causing this color change. or right at the beginning. At times, it can be due to hormonal changes that occur when changing between birth control as well.
  • Pregnancy: During the first trimester, some women experience spotting which can be brown in color. Though this doesn’t necessary imply that there is something wrong, it can indicate a miscarriage or ectopic pregnancy, requiring a doctor’s visit. In cases of a ‘missed miscarriage’, where the fetus stops developing but is not expelled immediately, some dark brown spotting may be seen.
  • Black: this usually resembles coffee grounds. Though an understandably alarming shade, this blood is usually present due to the same reasons as brown blood – old, slower moving blood that has become oxidized.
  • Blockage: if a vaginal blockage is the reason for black blood, other symptoms such as genital itching, foul discharge, urinary difficulties and fever may be present.
  • Dark Red: this is usually noticed after waking up or lying down, often occurring on your heaviest days. It indicates blood that has been in the uterus for a while, but not been oxidized to the point of turning brown or black. This can occur at the end of your period, where blood flow becomes slower, or with bleeding after delivery, as mentioned above.
  • Bright Red: this usually indicates fresh blood at the start of your period, when the blood flow increases on the 2nd or 3rd day due to the uterine lining shedding faster. It may remain the same color or change as your cycle progresses. However, when accompanied with heavier periods that last longer, bleeding after intercourse, foul smelling discharge, lower back pain and unexplained weight loss, this requires medical attention. Red blood is also associated with:
  • Infection: sexually transmitted infections such as chlamydia and gonorrhea can cause bleeding in between periods.
  • Pregnancy: bleeding during pregnancy needs to be looked into as it carries a risk miscarriage.
  • Polyps or Fibroids: noncancerous growths within the reproductive tract can cause bleeding along with other symptoms.
  • Pink: this is when blood is diluted with cervical fluid, at the start or end of the period, or during spotting. Though a common occurrence mid-cycle, watery spotting not related to your menstrual cycle can be a cause for concern, requiring a medical checkup.
  • Ovulation: at the release of the egg from the fallopian tubes, some pink spotting may be seen
  • Low Estrogen: this hormone helps in stabilizing the uterine lining, allowing shedding to happen in one go. When levels are low, the lining can shed at random causing spotting of various colors. It can indicate perimenopause, side effects of birth control or other conditions. At times it can be due to working out a lot.
  • Miscarriage: This occurs with additional symptoms of abdominal cramping and passing of tissues.
  • Orange: in the same way that blood mixed with cervical fluid can look pink, it can turn orange as well.
  • Implantation: this occurs when the fertilized egg embeds into the uterine lining and can cause spotting. The spotting occurs a few days before the expected period and is of a lighter flow compared to a usual period.
  • Infection: orange blood can signify an infection. This would often be accompanied by additional symptoms of vaginal itching and foul discharge. The color of blood and discharge can also change as the infection progresses.
  • Gray: this requires a medical checkup.
  • Infection: it may indicate infections such as bacterial vaginosis. There may be accompanying symptoms of fever, pain, itching, burning or painful urination and odor from discharge.
  • Miscarriage: this would be accompanied with grey tissues passing as well. Some describe this tissue as looking like “liver”.