Gynecologist called the causes of spotting discharge before and after menstruation

Smearing spotting 2-3 days before the onset of menstruation or within a few days after its end, some women consider an individual feature. However, Russian gynecologist-endocrinologist Svetlana Lizunova warns: this is not the norm and may indicate hormonal disorders, chronic inflammation or endometriosis. She told how to distinguish the norm from pathology and what to pay attention to, writes sb.by.

When discharge is the norm

- Normally, menstruation lasts up to 7 days, explains Svetlana Lizunova. All bleeding associated with it must be met by this time. There should be no brown spotting before or after. If menstruation has begun, ended, and on the 8th day they are not – this is the norm.

The doctor emphasizes: there is no causeless discharge. If they appear before or after menstruation, you need to look for the cause.

Three main causes

Hormonal disorders. Most often, this is the insufficiency of the second phase of the cycle, when the level of progesterone is reduced. In this case, the endometrium does not have time to fully prepare for implantation, explains the gynecologist. When it comes time to attach the fetal egg, the level of progesterone drops, and the tweaking begins.

Chronic endometrial inflammation. Even if smears and ultrasound are normal, changes may remain in the mucous membrane of the uterus after infections. - The body is one. Inflammation in the nasopharynx or urinary tract can affect the endometrium. This is so-called low-intensity inflammation, which is not always visible on standard tests, but it interferes with implantation, warns Svetlana Lizunova.

Endometriosis of the uterus. This disease is often manifested by spotting after menstruation, sometimes before it.

How to distinguish the cause by the nature of discharge

The doctor suggested a visual pattern:

If menstruation lasts 7 days, and then a few more days smear - it is more like endometriosis of the uterus body.

If spotting appears before and after menstruation, and the total duration of bleeding reaches two weeks - this may indicate chronic inflammation of the endometrium.

If scanty spotting begins in the second half of the cycle, a few days before menstruation, this is a sign of a lack of progesterone.

Clinical case

Svetlana Lizunova gave an example from practice: the patient could not get pregnant for a year. For six months, she was disturbed by brown discharge after menstruation. Two gynecologists said that everything was normal, and advised to just try to conceive. But it turned out that the woman reduced progesterone in the second phase and impaired blood flow in the endometrium.

- This is a slight malfunction of the ovaries, but there is no full ovulation and transformation of the endometrium. Without correction, implantation is impossible, and if pregnancy occurs, the risk of interruption in the early stages is high, the doctor explains.

What do you do

- It's not normal. It needs to be removed, — emphasizes Svetlana Lizunova. — If you are sent “just to try to get pregnant”, because nothing was found, it does not mean that there is no problem. It is necessary to check the hormones in the second phase, assess blood flow in the endometrium, exclude inflammation and endometriosis. Sometimes a comprehensive examination is required in different phases of the cycle.

The doctor urges women not to ignore spotting before and after menstruation and not to consider them an individual feature, especially if there are plans for pregnancy.