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Dark and light menstruation is usually normal and does not indicate any kind of he alth problem, especially if it appears at the beginning or end of menstruation. However, when this type of menstruation is recurrent, it can also be a sign of hormonal changes, uterine problems, stress or sexually transmitted diseases, for example.
In addition, when a woman starts taking the contraceptive pill for the first time, changes pills or uses the morning after pill, menstruation may also become darker or coffee grounds, returning to normal the next time cycle.
The ideal is that whenever the color of menstruation causes some kind of doubt, make an appointment with the gynecologist, to understand if there is any cause that needs more adequate treatment. See the main doubts about menstruation.
Black, brown or coffee grounds can be caused by:
1. Emotional changes
Some changes in a woman's emotional state, such as excess stress or the development of depression, can affect the structure of the uterus, decreasing the thickness of its walls. As a consequence, there is a delay in the desquamation of the uterine wall, facilitating the oxidation of the blood and making menstruation darker.
What to do: In these cases, it is important to invest in activities that help to promote a feeling of well-being, such as physical activity or other activities that help you relax.
2. Hormonal changes and menopause
When hormonal changes arise caused by thyroid problems, or even menopause, it is very common for menstruation to be dark and in small amounts. This change is also very common when changing the contraceptive pill or when the woman is no longer breastfeeding very often and the breastfeeding pill is not enough to prevent any bleeding.
What to do: In case dark menstruation is due to thyroid problems, it is important that thyroid hormone levels are checked so that the gynecologist can indicate the best treatment if necessary.
When it happens due to menopause or changing the contraceptive pill, it is not necessary to perform any type of treatment, however if other symptoms are present, it is important to consult the gynecologist so that an evaluation can be made.
3. Sexually transmitted infections
Some sexually transmitted infections caused by bacteria, such as chlamydia and gonorrhea, can cause menstrual blood to break down more quickly, making menstrual blood darker. In addition, this type of menstruation is usually accompanied by a foul smell, brown discharge before or after menstruation, pelvic pain and fever above 38º C. Check out other signs and symptoms that may indicate an STI.
What to do: In the presence of signs and symptoms indicative of an STI, it is important that the doctor is consulted so that treatment with the most appropriate antibiotic can be started. In addition, it is recommended that the couple undergo treatment, even if there are no symptoms, as this way it is possible to prevent reinfection.
Endometriosis consists of the growth of endometrial tissue outside the uterus, which can cause severe pain in the pelvic region and dark bleeding, like coffee grounds, which can happen both during the menstrual cycle and outside the cycle. In these cases, in addition to being dark, menstruation is also longer, and may take more than 7 days to finish.
What to do: In case of suspicion, go to the gynecologist so that exams can be performed that evaluate the uterus and pelvic region as a whole and, thus, it is possible to verify the severity of endometriosis and the need for surgery to treat endometriosis.
Another situation in which dark menstruation is normal is in the postpartum period when the uterus takes about 45 days to return to normal size, with bleeding throughout this period. At this stage, this bleeding is not exactly menstruation, but the color is dark and can confuse many women, but this is a normal and expected situation.
What to do: If the bleeding is persistent and other symptoms appear, it is important to consult the gynecologist so that an evaluation is carried out and, thus, it is possible know if it is normal or if treatment is necessary.
The presence of a small pink, brown or dark red bleed is considered normal in the first few weeks of pregnancy and is usually indicative that the embryo has implanted in the wall of the uterus.
However, when dark "menstruation" occurs in the later stages of pregnancy or is accompanied by other symptoms such as abdominal pain, shoulder pain, dizziness or excessive tiredness, it may be indicative of an ectopic pregnancy or miscarriage.
What to do: If dark menstruation happens towards the end of pregnancy, it is important that the doctor is consulted immediately so that tests are carried out to evaluate the development of the pregnancy and the cause of the symptoms can be identified.
When to go to the doctor
Usually changes in menstrual bleeding are normal and do not indicate problems, but the gynecologist should be consulted if other symptoms or signs such as:
- Menstruation lasting more than 7 days;
- Not having a period for more than 3 months;
- Having breakthrough bleeds;
- Pain in the intimate region;
- Fever above 38º C;
- Pale skin or under nails.
It is also important to remember that in cases of suspected pregnancy, the appearance of dark bleeding, in pieces or in large amounts is also a reason to seek medical attention because it may be a miscarriage, and it may be necessary to a curettage to clean the uterus.Check out the signs and symptoms that may indicate a miscarriage.