Dark, light menstruation is normally normal and does not indicate any type of health 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, problems with the uterus, stress or sexually transmitted diseases, for example.
Furthermore, 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 like coffee grounds, returning to normal in the next cycle.
Ideally, whenever the color of your period causes any doubt, you should consult a gynecologist to understand if there is any cause that requires more appropriate treatment. See the main questions about menstruation.
Main causes
Black, brown or coffee-ground menstruation 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, reducing the thickness of its walls. As a consequence, there is a delay in the desquamation of the uterine walls, facilitating blood oxidation and making menstruation darker.
What to do: In these cases, it is important to invest in activities that help promote a feeling of well-being, such as practicing physical activity or other activities that help you relax.
2. Hormonal changes and menopause
When hormonal changes occur caused by thyroid problems, or even menopause, it is very common for menstruation to be dark and in small quantities. This change is also very common when changing the contraceptive pill or when the woman is no longer breastfeeding very frequently and the breastfeeding pill is not enough to prevent any bleeding.
What to do: If dark periods are due to thyroid problems, it is important to check thyroid hormone levels so that the gynecologist can recommend the best treatment if necessary.
When it happens due to menopause or changing the contraceptive pill, it is not necessary to carry out any type of treatment, however, if other symptoms are present, it is important to consult a gynecologist so that an evaluation can be carried out.
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. Furthermore, 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 a doctor be consulted so that treatment can be started with the most appropriate antibiotic. Furthermore, it is recommended that the couple undergo treatment, even if there are no symptoms, as this way it is possible to prevent reinfection.
4. Endometriosis
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 occur both during the menstrual cycle and outside the cycle. In these cases, menstruation, in addition to being dark, is also longer and can take more than 7 days to end.
What to do: In case of suspicion, you should go to the gynecologist so that tests can be carried out to evaluate the uterus and the pelvic region as a whole and, thus, it is possible to verify the severity of endometriosis and the need for surgery to treat endometriosis.
5. Postpartum
Another situation in which dark menstruation is normal is in the postpartum period when the uterus takes around 45 days to return to its 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 a gynecologist so that an evaluation can be carried out so that it can be determined whether it is normal or whether treatment is necessary.
6. Pregnancy
The presence of a small amount of pink, brown or dark red bleeding is considered normal in the first weeks of pregnancy and is usually an indication that the embryo has implanted in the wall of the uterus.
However, when dark “menstruation” occurs in the final 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 occurs towards the end of pregnancy, it is important that the doctor is consulted immediately so that tests can be carried out to assess the development of the pregnancy and the cause of the symptoms can be identified.
When to go to the doctor
Normally 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 that lasts more than 7 days;
- Not menstruating for more than 3 months;
- Have breakthrough bleeding;
- Pain in the intimate region;
- Fever above 38º C;
- Dizziness;
- Paleness of the skin or under the nails.
It is also important to remember that in cases of suspected pregnancy, the appearance of dark, lumpy or large amounts of bleeding is also a reason to see a doctor because it could be a miscarriage, and it may be necessary to perform a curettage to clear the uterus. Check out the signs and symptoms that may indicate a miscarriage.
