We met Mandi when we discussed what period pain feels like. When she told us her story, she mentioned in a matter-of-fact way, that when she “saw the blood in my panties, I realised that my periods had arrived”. At the time, she didn’t mention three things. Firstly, that she’d never shared that story with anyone and, secondly, that the blood in her panties was dark brown. Almost black. She was a little scared.

Although Mandi’s experience was nearly 60 years ago, sadly many young girls and women still experience their first, and many subsequent periods: alone, frightened, and confused. In many communities, discussing menstruation and what happens to women’s bodies is still taboo – not allowed. However, this is beginning to change. Some of this is thanks to the internet and because women – and society – are recognizing that menstruation is a natural part of life.

It took a while for Mandi to learn that black blood was a normal part of her menstrual pattern and that the colour of the blood from her vagina changed during her period. This, too, is normal.^1,2

That’s a long way of saying that, no, black-period blood is not always a sign that something is wrong. However, there are times, though, when black blood is a reason to worry.

 

What can cause black blood or vaginal discharge?

A black vaginal discharge or black blood can be caused by a few things including infections which we’ll discuss below.

Black blood related to pregnancy

Black vaginal discharge or the appearance of black period blood can happen when you fall pregnant, and the embryo implants itself in the wall of your womb. It could also be a sign that you’ve had a miscarriage and you may or may not know that you were pregnant. You could have a “black period” if the foetus doesn’t develop and pass out of your body for more than four weeks.

When you’ve had a baby, you can have some bleeding about four to six weeks after the birth. This postpartum bleeding or lochia can be heavy and to begin with, may have red clots and slows down and changes to dark brown and even black blood after the fourth or fifth day.³

Infections

Most women have some sort of vaginal discharge almost every day and this is usually thin and clear or white. Often during the course of your cycle, it changes colour like when you have your period. The dark black or brown colour is usually old, oxidized blood that takes longer to come out of the uterus. This mostly comes with the symptoms we associate with our periods. However, if brown or black discharge happens outside our usual cycles, and with other symptoms, there could be an infection.

Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is when the neck of the womb (cervix) and the uterus are infected causing a brown discharge that can be smelly. With PID there are often other symptoms like pain in the hip area and lower abdomen, as well as during sex. Sometimes women can have a fever and experience burning when they pee (urinate).

If you experience these symptoms and think that you might have PID, go to the clinic or see your doctor.

Sexually transmitted diseases

Symptoms of a sexually transmitted disease (STI) can include (but not always) a smelly discharge, painful urination as well as pain during sex. PID can be a result of an STI such as gonorrhea or chlamydia and must be treated. Sometimes you can have an STI with no symptoms. People who are sexually active and especially those who have more than one partner are at risk of sexually transmitted diseases. If this describes your sex life, make sure that you stay healthy by getting tested regularly.⁴

Something could be stuck in your vagina

It’s also possible that an object like a contraceptive like a condom, diaphragm, or cervical cap could get stuck in your vagina. Even a sex toy could get stuck. Over time, these objects can irritate the vagina’s lining and cause an infection. This can result in black period blood as well as a smelly discharge, swelling, or itching around the vagina and genitals. Other symptoms include those we mentioned when we discussed PID above.

When women menstruate, some insert tampons, sponges, or other materials into their vaginas to absorb or catch the blood. If these get stuck, or if tampons stay in too long, they can cause infection including toxic shock syndrome.⁵ This can also happen when women and young people cannot afford sanitary products and use rags or mattress stuffing.⁶ Increasingly – the world over – women are moving away from disposing of sanitary products because of both their cost and the environmental damage. Properly used, menstrual cups and reusable sanitary pads are comfortable, affordable, and hygienic alternatives.⁷

 

When should you get medical attention?

As we keep on saying, women know their own bodies and their menstrual cycles. That means that you should go and see your health care professional if –

• anything changes in your cycle
• you experience any of the symptoms we’ve mentioned above, including irregular periods, bleeding, and pain between periods or
• you are pregnant and have any of the symptoms we’ve discussed in this article.

 

A last word

If, before you get to the doctor and you need to take something for the pain and fever, Cipladon tastes great and relieves pain and fever f-f-faster!

 

Disclaimer: The information on this site should not be used as a substitute for professional medical care or advice. Contact a health care provider if you have questions about your health.

Sources:

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1. WebMD Editorial Contributors, Brennan, D (reviewer), 2021. What to Know About the Color of Period Blood WebMD [Online] Available from https://www.webmd.com/women/what-to-know-color-period-blood 21/11/2022
2. Eske, J., Riggins Nwadike, V (Reviewer) 2019. What does the colour of period blood mean? Medical News Today, Headline Media [Online] Available from <https://www.medicalnewstoday.com/articles/324848> 21/11/2022
3. Malka, T., 2022 Black Discharge: Causes and What it Means. K Health [Online] Available from <https://khealth.com/learn/vaginal-discharge/black-discharge/> 21/11/2022
4. Burgess, L., Ernst, H (Reviewer). 2020. What causes brown discharge before a period? Medical News Today, Healthline Media [Online] Available from <https://www.medicalnewstoday.com/articles/321929> 21/11/2022
5. Higuera, V., Soliman, M (Reviewer) 2022. Understanding Toxic Shock Syndrome (TSS) Medical News Today, Healthline Media [Online] Available from <https://www.healthline.com/health/womens-health/black-discharge> 21/11/2022
6. Guardian News and Media 2017. Having a Period Is Unaffordable in Kenya, Yet No One Wants to Talk about It. [Online] Available from <https://www.theguardian.com/global-development-professionals-network/2017/jan/05/having-a-period-is-unaffordable-in-kenya-yet-no-one-wants-to-talk-about-it> 21/11/2022
7. van Eijk, A. M. et al. 2018 Use of menstrual cups among school girls: Longitudinal observations nested in a randomized controlled feasibility study in rural western Kenya – Reproductive Health. BioMed Central [Online] Available from <https://reproductive-health-journal.biomedcentral.com/articles/10.1186/s12978-018-0582-8> 21/11/2022