Brown discharge 1 week before period every month

[CLM0525]

I was on birth control for approximately 6 years before all of this started happening. I stopped birth control 18 months ago, and began charting my cycles as a means of birth control: temperature and mucous checks (I am 27 years old and married with only 1 sexual partner before my husband). For 18 months, since coming off birth control, I have been experiencing brown discharge, sometimes mixed with bright red blood, 6-7 days before my actual period starts. My actual periods are normal lengths (5-7 days), and my cycles are typically 28-31 days. I do not have pain during intercourse and I have only noticed a bit of spotting one time after intercourse, however, this was right before this abnormal discharge was due to start. I experience cramps during the first 1-2 days of my period but they do not interfere with my daily routines or work. I have always had normal pap smears, however, in April of this year I had an abnormal pap of unspecified cause (this pap smear was taken during my abnormal discharge 1 week before my period started). HPV, chlamydia, and gonorrhea were tested and all came back negative. Two weeks later, I went back to my CNM because I was pretty sure I had a yeast infection. Upon examining me she stated my cervix bled a bit when she swabbed. I was treated for the yeast before my culture came back because she was sure that's what I had and I didn't want to wait a week for my culture results. When my results did come back, she said I did indeed have a yeast infection (which by then had cleared up from the meds) and that I also had BV. She asked if I had foul smelling discharge or itching and I did not, so she did not treat me for BV. I had pelvic and transvag ultrasounds in May to further investigate this abnormal discharge. Everything was completely normal. I had a follow up pap 6 months later, Oct 1, which came back normal. During the pap smear my CNM said everything looked healthy and normal.  One week later, I started seeing an OBGYN (Oct 9th) to further investigate my abnormal discharge. I was currently having abnormal discharge when I saw this OBGYN because it was 1 week before my period was to start. Upon examination he said I had a lot of brown discharge and that my cervix bled when he touched it. He ordered ultrasounds for next week and we are going from there. I feel the brown discharge is hormone or cycle related because it is so cyclical in nature...every month at the same time. However, the cervix bleeding is what worries me. It has happened twice that I know of, at examinations with 2 different professionals (OBGYN and CNM). This month I only wore pads and did not use tampons during my period because I am hoping it will help the issue. I should also point out my hormone and thyroid levels were all tested through bloodwork taken during my follicular phase (which I feel now that I know more was not the best time). Everything came back "normal" according to the CNM, however, I am still concerned with my LH/FSH levels which were approx 2.5:1 ratio, my LH was around 15 and my FSH was around 5.7. My OBGYN didn't seem concerned with that ratio due to my normal testosterone and no other symptoms of PCOS. I think he is taking it one step at a time, ultrasounds, the maybe scope of uterus and cervix, maybe progesterone test with a sample on a certain day of my cycle or something. What do you think of all of this and what is your opinion?

[lin121904]

omg... I am feeling the same way.  one week before my period I get the brown discharge.  

[CLM0525]

Update: no infection. Colposcopy showed mild cervical ectropian/erosion that didn't need to be treated because it's not causing me any bothersome symptoms.  No abnormal cells on cervix. Very good news overall. I'd like to point out i did not use tampons last month and this month i am in the week leading up to my period and have had no brown discharge.  Possibly the Tampons were irritating the cervical erosion.

[CLM0525]

I went today for my swab to test for infection but of course have to wait 1 week for results. My obgyn said my cervix looked little red and that I had a lot of discharge, which I have been told before. He didn't notice if my cervix was bleeding today because he didn't need to touch it since there was discharge around it that he could grab for the swab. I am going for bloodwork on the 21st day of my cycle to test my progesterone to make sure I'm ovulating.  He also wants to do a colposcopy to closer examine my cervix since I did have an abnormal pap 6 months ago. What I'm confused about is why I need the scope if I had a follow up pap this month which was normal? He mentioned the possibility of cervical erosion which could cause the redness of cervix and bleeding when it's touched. He wants to make sure I don't have an underlying infection causing this monthly abnormal discharge before doing the scope. More questions and waiting...

[CLM0525]

My ultrasound results were completely normal.  I had a few tiny follicular cysts on my left ovary which I was told were normal and harmless. I also had a couple vericose veins near my left ovary and was also told they were harmless. Good news, but more questions.  I'm going tomorrow for a swab to check for infection. I will keep updating my findings since this has been a long and tiresome road. I hope someone else will find this post helpful.

[CLM0525]

Yes I feel there are so many things that need to be ruled out still. Like I said I had a normal pap earlier this month and all my bloodwork was normal apart from the lh fsh ratio that I'm still concerned about but my obgyn is not.  What do you think of that? Thank you for your comment,  I will let you know how my appt goes tomorrow.

[Bhupinder Kaur, MD]

Hello,
Brown vaginal discharge is most often associated with old endometrial tissues. In other words, if your period is late you might get a brown, rather than red, discharge. It could also mean that for whatever reason during your last menses the entire uterine lining failed to make a timely exit. This brown vaginal blood with discharge can also be due to your old blood retained after periods or it can possibly be implantation bleeding in case you are pregnant.
Other causes could be polycystic ovarian syndrome, diseases of pituitary gland, hormonal imbalance of estrogen and progesterone and uterine abnormalities like fibroid and  cervical dysplasia. If you are bleeding from the cervix then cervicitis and cervical dysplasia should be ruled out.
It is very difficult to precisely confirm a diagnosis without examination and investigations and the answer is based on the medical information provided. For exact diagnosis, you are requested to consult your doctor. I sincerely hope that helps. Take care and please do keep me posted on how you are doing.