What’s the Deal with the Brown Discharge Before Your Period?

Although some women have basically regular periods, there is always a small amount of spotting or bloody discharge a few days before each official period before the official period is ushered in (heavier and brighter in color, with shedding of the uterine lining, accompanied by typical menstrual symptoms such as lower abdominal cramps and lower back pain).

Bleeding outside of menstruation is always a difficult concern, so how does this phenomenon occur?Is it harmful?Is it necessary to visit a doctor?Let’s see if this article can help take the doubt out of your mind.

Fundamentals of menstruation

To figure out the causes of premenstrual bleeding, you need to understand the basics of menstruation first.The lining of our uterus is covered with endometrium, and just as the skin is divided into a dermal layer and an epidermal layer, the endometrium is also divided into two layers.The top layer is the functional layer, the part that is shed with each menstrual period.The inner layer is the basal layer, which is responsible for producing new functional layers.

At the end of a menstrual period, the old functional layer of endometrium is shed and a new crop of functional layer grows up slowly with the support of estrogen.After the follicle expels the egg, the remaining portion becomes the corpus luteum, which produces estrogen and progesterone to support further thickening and development of the endometrium, making it ready for embryo implantation.If there is an early embryo implantation, the blood vessels and glands of the functional layer can support the further development of the embryo; if there is no conception, the corpus luteum will lose its function 14 days after ovulation, the estrogen and progesterone will decline rapidly, and the endometrium will shrink and fall off due to the loss of estrogen and progesterone support from the corpus luteum, accompanied by the fracture of the small blood vessels, bleeding, and exudation, and together they will be discharged as the menstruation.Therefore, menstruation is essentially a product of the renewal of the uterine lining, and hormones and the lining all play a key role in the formation of menstruation.With this clear, it is easier to understand why there is premenstrual bleeding: both hormonal fluctuations and endometrial abnormalities can be the cause of premenstrual bleeding.

Possible causes of premenstrual bleeding

1 Premenstrual bleeding due to hormonal fluctuations

Estrogen and progesterone support the growth and development of the endometrium, and if there are significant enough hormonal fluctuations prior to menstruation to affect the stability of the endometrium, this can lead to a small amount of endometrial bleeding.Endogenous hormonal fluctuations can be caused by factors such as luteal insufficiency, disturbance of hyperprolactinemia during lactation, immature ovarian function during puberty, perimenopausal ovarian decline, and polycystic ovary syndrome. Stress, sleep, weight changes, dietary changes, and environmental changes can also contribute to premenstrual bleeding by affecting hormone production.Exogenous hormonal fluctuations, such as oral intake of hormone-containing medications (e.g., emergency contraceptive pills, short-acting contraceptive pills), use and discontinuation of drug-containing intrauterine devices, etc., can also affect the hormonal balance in the body, triggering premenstrual bleeding.

2 Premenstrual bleeding due to endometrial abnormalities

A healthy endometrium can withstand a certain range of hormonal fluctuations, and minor hormonal fluctuations can lead to endometrial bleeding if there are lesions in the endometrium or if it is affected by some diseases.Some infectious diseases, such as endometrial inflammation, can manifest as spotting before menstruation.Sometimes, diseases such as endometrial polyps, uterine fibroids, endometriosis, etc. can also affect the stability of the endometrium, and symptoms of premenstrual bleeding can occur.Some systemic diseases, such as abnormal thyroid function, abnormal coagulation function, abnormal platelet function, etc., can also occur premenstrual bleeding.

3 “Premenstrual bleeding” due to pregnancy

Sometimes pregnancy can cause symptoms similar to premenstrual bleeding.This is the period around 10 days after normal conception when the embryo settles in the womb, and sometimes bleeding occurs at this stage. The amount of bleeding is usually small and stops on its own, with no obvious discomfort, which leads many people to think that they are having pre-menstrual bleeding or a menstrual period with a small amount of blood, thus delaying the judgment of pregnancy.However, bleeding on implantation neither jeopardizes a woman’s health nor affects the development of the embryo, so the danger is minimal, while the other situation is much more dangerous.

A small amount of bleeding from the lining of the uterus can also result if the embryo does not settle properly and instead an ectopic pregnancy (also commonly known as an ectopic pregnancy) occurs.This bleeding can occur either at the expected time of menstruation or before or after the expected period, so it is often mistaken for premenstrual bleeding or abnormal menstruation, which can delay treatment.

Even if the embryo is normally implanted in the uterus, there may be a number of reasons for the manifestations of pre-menstrual miscarriage, such as vaginal bleeding, lower abdominal pain, and uterine effusion, which can sometimes be confused with pre-menstrual bleeding or abnormal menstruation.

4 Other reasons

Bleeding caused by some cervical lesions can also manifest similarly to premenstrual bleeding.Diseases such as chronic cervicitis, cervical polyps, and cervical cancer can make the cervical tissues fragile and congested, so it often manifests itself as vaginal bleeding after intercourse. Bleeding symptoms can range from spotting, bloody vaginal discharge, to a small amount of vaginal bleeding and an increase in menstrual flow.It can also be misdiagnosed as premenstrual bleeding if it happens to occur just before menstruation.

When to seek medical attention

The causes of premenstrual bleeding are complex, and there are a number of specific conditions that need to be identified, so the need to seek medical attention also depends on the specific situation.In the case of occasional premenstrual bleeding, priority needs to be given to determining whether there is a possibility of pregnancy.If pregnancy is possible, medical confirmation of pregnancy is needed to rule out ectopic pregnancy, etc. If pregnancy is unlikely, observation can be made for the time being.Bleeding caused by occasional hormonal fluctuations, medication, etc. can often improve on its own when the irritating factor is removed.If premenstrual bleeding occurs frequently, if it occurs at other stages of menstruation, if it is heavy, if it smells bad, or if premenstrual bleeding is accompanied by vulvovaginal discomfort, lower abdominal pain, unexplained fever, unexplained weight loss, or fatigue, you need to consult a doctor.If you are preparing for pregnancy, or if your early pregnancy is confirmed, you also need to inform your doctor about the vaginal bleeding.