Endometrial tissue discharge refers to the shedding of the lining of the uterus (endometrium) that occurs during menstruation. The discharge can vary in color, texture and amount depending on the stage of the menstrual cycle. Understanding what is normal vs. abnormal endometrial tissue discharge can help identify potential gynecological issues.
What Causes Endometrial Tissue Discharge?
The endometrium grows and thickens during the follicular phase of the menstrual cycle under the influence of estrogen. If pregnancy does not occur, estrogen and progesterone levels drop leading to breakdown and shedding of the endometrial lining. This causes bleeding and discharge of endometrial tissue fragments and blood through the vagina.
The cyclical build up and breakdown of the endometrium is controlled by the rise and fall of reproductive hormones. Irregularities in hormone balance can lead to abnormalities in the menstrual cycle and endometrial tissue discharge.
What Does Normal Endometrial Discharge Look Like?
Color
Normal menstrual discharge is usually a light to dark red or brown color. The red color comes from fresh blood. Brownish discharge occurs from older blood that has taken longer to exit the body.
At the beginning and end of your period, the discharge tends to be darker brown/red as the flow slows down. Bright red blood that soaks a pad or tampon within an hour may indicate heavy menstrual bleeding.
Texture
The texture of normal endometrial tissue discharge can range from thin and watery to thick and gelatinous. Menstrual fluid is made up of blood, vaginal secretions, and endometrial tissue. Changes in estrogen levels during the cycle can affect cervical mucus production leading to variation in texture.
Thick, clotted blood is common at the beginning of a period. Small clots or “gelly-like” discharge may come out with heavier flow as the uterus contracts to expel its lining. Stringy discharge that stretches an inch or more indicates thick mucus.
Amount of Flow
The average menstrual flow contains around 2 to 3 tablespoons of blood lost over a 3 to 7 day period. However, normal menstrual volume can range widely from light to heavy. What is normal for one woman may not be typical for another.
Going through a pad or tampon more frequently than every 2 hours, or passing large clots larger than a quarter, are signs of a heavy flow. If you consistently bleed heavily or for more than 7 days, see your doctor.
What Does Abnormal Discharge Look Like?
Certain colors, textures and amounts of discharge may indicate health issues that require medical attention:
Abnormal Colors
– Grey or white: Thick, cheesy-white discharge may signal a yeast infection. Grey/white streaks or a foul smell could point to bacterial vaginosis.
– Yellow/green: Yellow or green discharge accompanied by itching, burning and swelling suggests trichomoniasis, an STD caused by a parasite.
– Pink or brown when not menstruating: This can occur with ovulation but pink or brown discharge at other times may be a sign of cervical cancer if accompanied by foul odor, pelvic pain or bleeding between periods.
Abnormal Textures
– Frothy or foamy: Bubbly discharge may be due to increased secretions from vaginal wall irritation or infection.
– Cottage cheese-like: White, lumpy discharge is commonly caused by yeast infections.
– Watery: A thin, clear and watery discharge could indicate bacterial vaginosis.
Abnormal Amounts
– Heavy bleeding with large clots: Flooding through pads or tampons hourly or passing clots bigger than a quarter signals heavy menstrual bleeding that should be evaluated.
– Spotting between periods: Light bleeding between regular periods can have many causes including thyroid disorders, polyps or cervical cancer.
– Bleeding after menopause: Any amount of bleeding after menopause is abnormal and needs medical assessment to check for cancer.
When to See a Doctor
See your gynecologist or healthcare provider if you notice any of the following:
– Foul-smelling discharge
– Vaginal itching, burning or irritation
– Discomfort during sex or urination
– Unusual vaginal bleeding between periods or after menopause
– Heavy periods making you double up on pads/tampons every 1-2 hours
– Bleeding for longer than 7 days
– Abdominal or pelvic pain
Diagnosing Abnormal Vaginal Discharge
To diagnose causes of abnormal discharge, your doctor may:
– Ask about your symptoms and medical history
– Perform a pelvic exam to visually check for signs of infection, cancer or anatomical abnormalities
– Take a sample of the discharge to test for infectious organisms like yeast or bacteria
– Order blood work to check hormone levels and rule out thyroid disorders
– Perform an ultrasound to look for uterine fibroids, polyps, ovarian cysts or other pelvic issues
– Do a Pap smear to screen for precancerous cervical cell changes
– Carry out an endometrial biopsy getting a sample of the uterine lining to check for cancer or other abnormalities
– Schedule specialized tests like a hysteroscopy (using a camera to see inside the uterus) or colposcopy (visually examine the cervix) if cancer is suspected
Treatment Options for Abnormal Discharge
Treatment depends on the underlying cause but may include:
Infections
Bacterial vaginosis, yeast infections, trichomoniasis and other STDs can be treated with oral or topical anti-fungal medications, antibiotics, antiprotozoal drugs or antivirals. Your partner may also need treatment.
Hormonal Causes
Birth control pills, progestin therapies and other hormonal treatments may regulate abnormal bleeding from imbalances in estrogen and progesterone.
Structural Problems
Polyps, fibroids, ovarian cysts or anatomical defects are treated by surgically removing or shrinking the abnormal growths. Endometrial ablation destroys the uterine lining to control heavy bleeding.
Cervical Cell Changes
Precancerous cervical dysplasia is monitored or removed by freezing (cryotherapy), laser therapy, LEEP excision or conization biopsy. Cervical cancer has better outcomes with early aggressive treatment.
Endometrial Hyperplasia or Cancer
Hyperplasia is treated with progestin therapy and monitoring. Endometrial cancer involves surgery to remove the uterus, ovaries, fallopian tubes and lymph nodes, as well as radiation, chemotherapy or hormone therapy.
When to Seek Emergency Care
Seek prompt emergency medical care for:
– Heavy bleeding that soaks through a pad/tampon each hour for 2-3 hours
– Severe abdominal or pelvic pain
– Fever, nausea, vomiting or feeling faint – may indicate infection
– Foul-smelling vaginal discharge with lower abdominal pain – could be pelvic inflammatory disease
– Bleeding during pregnancy – threatened miscarriage
– Bleeding after menopause
– Bleeding after sexual intercourse
Preventing Abnormal Discharge
You can lower risks of unhealthy discharge by:
– Practicing safe sex using condoms to prevent STDs
– Avoiding douches, scented soaps or sprays around the vaginal area
– Wearing cotton underwear and loose clothes
– Urinating before and after sex
– Taking showers rather than baths
– Not using tampons for more than 8 hours – change frequently
– Maintaining healthy estrogen levels through diet, exercise, sleep
– Stopping smoking which increases cervical cancer risks
– Getting regular Pap smears and pelvic exams
When to Follow Up After Treatment
Follow up with your gynecologist:
– After finishing antibiotics or anti-fungal medications to confirm the infection cleared
– Within a month of a LEEP procedure or cervical biopsy to discuss pathology results
– Every 3-6 months after treatment for precancerous cervical changes
– Annually for a Pap smear after any abnormal Pap results
– Every 6 months if being monitored for endometrial hyperplasia
– As recommended after surgery, chemo or radiation therapy for gynecologic cancers
– Report any return of symptoms like foul odor, bleeding, pain, discharge
Living with Abnormal Discharge
Coping with abnormal vaginal discharge:
– Communicate openly with your doctor about symptoms, treatments and any discomfort
– Take medications as prescribed and finish entire course of antibiotics
– Avoid irritants like douches, perfumes or deodorant tampons
– Maintain vaginal health with probiotics and pH balancing gels if recommended
– Use panty liners to manage discharge and prevent staining
– Avoid strenuous exercise, tampons and sex during heavy discharge
– Plan ahead for discharge when outings, travel or intimacy – bring extra supplies
– Check in with your feelings – seek support from loved ones, therapist or support groups
– Be patient through diagnosis and treatment – healing takes time
Outlook for Abnormal Endometrial Discharge
With appropriate diagnosis and treatment, the outlook for abnormal vaginal discharge is good in most cases. Infections typically resolve fully with medications. Benign growths can be removed surgically. Close monitoring and early treatment of precancerous changes gives a very favorable prognosis.
Certain causes like recurrent yeast infections or repeat HPV infections may require ongoing management. Cancers detected at early stages have better outcomes. Seek evaluation for any persistent abnormal discharge to obtain an accurate diagnosis and proper treatment. Share concerns openly with your healthcare provider.
Conclusion
Endometrial tissue discharge can range widely in color, texture and amount depending on menstrual cycle phase and underlying gynecologic health. While some variations are normal, certain changes from a woman’s usual discharge may signal infections, hormonal issues, anatomical problems or, rarely, cancer. Discussing symptoms with a doctor can determine whether evaluation and treatment are needed. With proper care, most causes of abnormal discharge carry a good outlook. Staying aware of one’s cycle and seeking care for any concerning symptoms can help maintain gynecological well-being.