Dark menstruation: 6 causes and when to worry

Generally, dark menstruation and a small amount is normal and does not indicate any health problem, especially if it appears at the beginning or end of menstruation. However, when this type of menstruation is recurrent, it can be a sign of hormonal changes, problems in the uterus, stress or sexually transmitted diseases, for example.

In addition, when a woman starts taking the birth control pill for the first time, changes the pill or uses the morning-after pill, menstruation can also get darker or coffee grounds, returning to normal in the next cycle.

Main causes of dark menstruation

Black, brown or coffee grounds can be caused by:

1. Pregnancy

The appearance of small brown, pink or dark red bleeding is common in the first weeks of pregnancy, as it is related to the moment when the embryo is attached to the walls of the uterus. Find out here what are the signs that may indicate that there was fertilization, and that therefore you may be pregnant.

However, when this bleeding occurs at a later stage of pregnancy or is accompanied by other symptoms such as abdominal pain, shoulder pain, dizziness or excessive weakness, it may indicate the development of ectopic pregnancy or abortion, and it is recommended to go to the obstetrician to confirm if there is any problem.

2. Emotional changes

Some changes in the 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. This change delays the desquamation of cells and, therefore, facilitates the oxidation of blood, making menstruation darker.

3. Hormonal changes and menopause

When hormonal changes occur due to 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 too often and the breastfeeding pill is not being enough for there to be no bleeding.

4. Sexually transmitted diseases

Sexual diseases caused by bacteria, such as gonorrhea or chlamydia, for example, cause a faster breakdown of menstruation blood, 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 for other signs and symptoms that may indicate an STD.

5. Endometriosis and other conditions

Endometriosis consists of the growth of endometrial tissue outside the uterus. This type of problem and other conditions such as adenomyosis can cause severe pain in the pelvic area and dark bleeding, like coffee grounds, which can happen both inside and outside menstruation.

In these cases, menstruation in addition to dark is also longer, and may take more than 7 days to end. In case of suspicion, you should go to the gynecologist so that he can observe, order tests and indicate the antibiotics you can take, or other treatment, such as surgery, for example.

6. Postpartum

Another situation in which dark menstruation is normal, is in the postpartum period in which the uterus takes about 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.

If menstruation also comes with clots, read Why did menstruation come in pieces?

When to go to the doctor

Changes in menstrual bleeding are usually 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;
  • Without menstruating for more than 3 months;
  • Exhaust bleeds;
  • Pain in the intimate region;
  • Fever above 38º C;
  • Dizziness;
  • Paleness on the skin or below the nails.

It is also important to remember that in cases of suspected pregnancy, the appearance of dark bleeding, in pieces or in large quantities is also a reason to see a doctor because it may be a miscarriage, and it may be necessary to do a curettage to clean the uterus. Check for signs and symptoms that may indicate a miscarriage.