Brown Discharge: Causes and When to Seek Help

Having experienced brownish blood flow for a month?

Since my menstrual period ended last month, I have been experiencing intermittent brownish discharge for a total of one month.
A few days ago, I visited a gynecologist who performed an ultrasound and found that I have a 5 cm uterine cyst.
The doctor prescribed me medication to induce my period and advised me to return for further examination after this month's cycle.
However, I have done some research and read many articles stating that cysts do not typically cause brownish discharge.
Additionally, I have been having issues with bowel movements, as there is blood present every time I defecate, and the brownish discharge continues.
Should I consider getting a Pap smear for further evaluation?

Zhang, 20~29 year old female. Ask Date: 2016/11/15

Dr. Lü Lizheng reply Obstetrics and Gynecology

Based on your description, the cystic mass may be caused by irregular menstruation, and treatment with menstrual regulation medications can be considered.
Of course, it is also important to consider the possibilities of cervical cancer, pregnancy, and polyps, although these are less likely.
You can wait until the menstrual regulation medications have controlled the bleeding before scheduling a Pap smear.
Sincerely, Dr.
Lu Li-Cheng.

Reply Date: 2016/11/15

More Info

Brown discharge, particularly after your menstrual period, can be concerning and may indicate various underlying conditions. The presence of brown discharge typically signifies old blood that has taken longer to exit the body, which can happen at the end of a menstrual cycle. However, since you have been experiencing this for an extended period (about a month) and have also reported other symptoms, it is essential to consider a more comprehensive evaluation.

From your description, it seems that you have already consulted a gynecologist who performed an ultrasound and identified a 5 cm uterine fibroid (often referred to as a leiomyoma). Fibroids are benign tumors of the uterus that can cause a variety of symptoms, including abnormal bleeding, pelvic pain, and pressure symptoms. While it is true that fibroids can lead to irregular bleeding, the brown discharge you are experiencing may not be directly caused by the fibroid itself. It could be related to hormonal imbalances, endometrial issues, or other gynecological conditions.

The fact that you are also experiencing blood during bowel movements raises additional concerns. This could indicate a separate issue, such as hemorrhoids or anal fissures, but it is crucial to rule out any more serious gastrointestinal conditions. Blood in the stool should always be evaluated by a healthcare professional, as it can be a sign of various conditions, some of which may require immediate attention.

Regarding your question about whether a Pap smear (cervical cytology) is advisable, it is generally a good idea to have this test done, especially if you are experiencing abnormal bleeding. A Pap smear can help detect cervical changes that may indicate precancerous conditions or cervical cancer. It is typically recommended for women starting at age 21 and should be performed every three years, or every five years if combined with HPV testing, depending on your age and health history.

In your case, since you have ongoing symptoms, including the brown discharge and rectal bleeding, it would be prudent to discuss the following with your healthcare provider:
1. Further Evaluation of the Fibroid: Depending on your symptoms and the size of the fibroid, your doctor may recommend monitoring it or considering treatment options, which could include medication or surgical intervention if necessary.

2. Investigating the Source of Rectal Bleeding: It is essential to address the blood in your stool. Your doctor may recommend a gastrointestinal evaluation, which could include a colonoscopy, especially if you are over 50 or have risk factors for colorectal disease.

3. Hormonal Assessment: If your bleeding patterns are irregular, a hormonal evaluation may help determine if there are underlying issues that need to be addressed.

4. Follow-Up Care: Make sure to follow up with your gynecologist after your next menstrual cycle, as they may want to reassess your symptoms and the fibroid.

In summary, while brown discharge can be a normal occurrence, the duration and accompanying symptoms you are experiencing warrant further investigation. It is essential to maintain open communication with your healthcare provider and ensure that all your symptoms are thoroughly evaluated to arrive at an accurate diagnosis and appropriate treatment plan.

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