Period Blood Color — What does it mean and what’s normal?

Have you ever started your period and noticed the blood was brown, black, red, or even purple? Or, maybe you’re like most women, and you’ve never paid attention to the color of your menstrual blood — until you saw something out of the ordinary and panicked.

The variations in period blood colors are usually not pathological from a medical perspective. But they can be used to identify certain hormonal imbalances and nutrient deficiencies, or even infections. It’s a helpful piece of information physicians can use to determine what kind of labs and testing to order when trying to reach a diagnosis. 

For the most part, though, there’s nothing to panic about if you notice a strange hue to your menstrual blood.

Where does the color in period blood come from?

The main factor causing a variation in the color of period blood is simply oxygen. When blood (menstrual or otherwise) is exposed to oxygen, the color changes. It gets darker, usually maroon or brown. You’ve probably seen this phenomenon on a band-aid or pad.

Some other common reasons period blood colors may fluctuate include:

  • Hormonal imbalances
  • Excess estrogen
  • Low levels of estrogen
  • Pace of endometrial shedding
  • Bacterial Vaginosis
  • Improper diet
  • Nutrient deficiencies
  • Sexually transmitted infections
  • Cervical cancer

What causes changes in the color of period blood?

When the uterine lining sheds, it doesn’t happen all at once. Things can start off slowly — and as the first pieces of the endometrium break away, they have to make the journey down through the cervix and into the vagina. 

Then the shedding gets faster as you approach the middle of your menses. And towards the end of your cycle, things slow down again.

When your endometrium is shedding slowly (like at the end of your period), the pieces are being exposed to oxygen longer and therefore they’re going to be darker. When it’s moving quickly into the vagina (usually beginning to mid-cycle), the blood will appear brighter red in hue, since it’s had less time outside of the blood vessels.

The 7 colors of the period blood rainbow:

1. Dark Red or Brown Period Blood

This shade usually appears at the beginning or end of your cycle. Again, it’s usually just an indicator of how quickly the blood is exiting your body. 

Darker blood indicates normal, rising levels of estrogen. It could also point to a thicker uterine lining.

Hormonal birth control can affect the thickness of the uterine lining, which in turn can mean a brownish color of period blood. If you’re just starting the pill and noticing the color of your blood changing, this could be why. Also — be sure and check out this article on reducing the side effects of hormonal birth control.

Sometimes, when a fertilized egg implants into the endometrium, a small bit of blood is discharged — this is called implantation bleeding and is usually a brownish color. So if you’re finding a small bit of brown blood and you’re not on your period, it could mean you need to buy a pregnancy test…especially if you’re also experiencing:

  • Extreme fatigue
  • Breast tenderness
  • Nausea
  • Vomiting

If you’re noticing a brown bloody discharge after giving birth, this is completely normal — it’s called lochia. 

Dark brown bleeding can also be a hallmark symptom of Polycystic Ovarian Syndrome (PCOS). If your period blood is brown and you’ve noticed any of the following, it’s best to follow up with your doctor:

  • Irregular cycle
  • Acne
  • Weight Gain
  • Unusual hair growth 
  • Infertility

In fact, if you’re ever concerned about your period, discharge or hormones then it’s a good time to make a doctor’s appointment.

2. Bright Red Period Blood

This is usually the optimal place to be and most women will see this kind of color in the beginning to middle of their period. 

Bright red period blood indicates a normal, healthy flow. 

As your uterine lining sheds faster, the blood exiting your body is brighter. Nothing at all to worry about if you have bright red blood at any time throughout your flow.

One caveat here: if you’re seeing bright red blood but it’s not during your period, there could be an issue. Uterine fibroids, sexually transmitted infections (like gonorrhea, and chlamydia) and even cervical cancer can cause bright red bleeding between menses. If you experience bleeding after sex or in between periods, please visit your doctor.  

It’s also important to note that even if you have a perfect bright red hue to your period blood, you can still have a hormonal imbalance or any other myriad of issues. Again, it’s just one piece of the puzzle to consider.

3. Black Period Blood

You may have noticed a very dark brown or black color on a pad or tampon, especially at the end of your period. Although it may seem alarming, it’s simply an indication that things are moving slowly.  

Many women shed their uterine lining at a slower pace — and that’s all that extremely dark color to your period blood means. 

Black blood could even be a small leftover remnant from your last cycle getting expelled.

4. Pink Period Blood

If you notice light pink spotting mid-cycle, it’s probably just an indicator that you’re ovulating and not cause for concern. Not all women experience this, but those that do typically report just a small amount of light pink blood.

If you’re seeing pink blood during your period, it could mean low levels of estrogen thanks to perimenopause, primary ovarian insufficiency, or the birth control pill. 

In Beyond the Pill, I explain ways to get your hormone levels back on track after being on hormonal birth control.

A pink shade of period blood could also mean anemia, lack of proper diet that meets your needs, or possibly perimenopause. Check out my free detox diet to help get you started if you want to optimize your nutrition.

Often, a pink color means that the blood from your period is mixing with cervical fluid and it’s getting diluted. This could be a possible sign of infection. 

It’s best to talk things over with your doctor if you’re experiencing pink blood during your period, and especially if you’re pregnant or notice pink blood between periods. It can be a sign of cervical cancer. Not trying to scare you, but when in doubt, please meet with your doc and get it checked out.

Pink period blood may be due to low estrogen, primary ovarian insufficiency, perimenopause or birth control

5. Purple Period Blood

Sometimes, a deep purple tint creeps into period blood.

It’s a possible indicator of excess levels of estrogen — which can be managed with a proper, hormone balancing diet like the one in this completely free meal plan.

An overall increase in dietary fiber intake can also help to expel estrogen.

My Balance Women’s Hormone Support formula does wonders for supporting your liver in clearing excess estrogen out of your system too. It includes DIM, broccoli seed extract, and Calcium D-Glucarate to help remove  estrogen in the gut and assist the liver in processing it.

Usually, purple period blood is not a cause for worry. 

But, when you notice purple blood accompanied by:

  • Large clots (bigger than the size of a quarter)
  • Sharp, stabbing pains
  • Intense cramps
  • Extremely heavy flow

Then it’s best to contact your healthcare provider so they can evaluate you for the possibility of endometriosis, fibroids or anemia.

6. Orange Period Blood

When your period blood is orange in color but normal in consistency and smell, it’s likely nothing to worry about.

However, if the blood is orange and sticky, or if you have a fever and/or severe pain in your abdomen — it’s possible there’s an infection going on. 

Bacterial vaginosis or sexually transmitted infections can result in an orange-hued discharge that’s accompanied by a strong odor and vaginal irritation.

Definitely contact your physician if you’re having any of these symptoms.

7. Gray Discharge

A gray discharge during your period is typically an indication of bacterial vaginosis. This is when your vaginal flora becomes unbalanced and an infection takes over. I go into this condition in detail in this article on bacterial vaginosis.

Bacterial vaginosis is common and can easily be treated with the help of your healthcare provider.

If you are experiencing gray discharge and/or:

  • Fever
  • Strong Odor
  • Itching
  • Redness

It’s best to call your doctor and explain your symptoms.

Can the pill affect the color of my period blood?

Absolutely.

The color of your period blood while taking hormonal birth control will likely be different than the color it is without it.

As I discuss in Beyond the Pill, because the pill works by preventing ovulation and the endometrium from growing thicker, the bleeding you experience while taking it isn’t a true “period.” 

It’s actually withdrawal bleeding from the medication. This bleeding can be lighter in flow and darker in color than what you’re used to without it. Sometimes, just a tiny bit of brown blood is all you’ll see when on oral contraception. Other women will have no bleeding at all…

Breakthrough bleeding (spotting or bleeding in between cycles) is also common on the pill — and IUD’s for that matter, especially during the first few months of use. This blood can be light red to dark brown. 

Also — check out my comprehensive contraception guide here to learn everything you need to know about all of your options for pregnancy prevention. 

Your estrogen levels will likely be affected by the pill too — this can mean your withdrawal bleeding will also likely be a different color than what you were used to pre-birth control.

The pill can also trigger nutrient deficiencies, which can cause changes in your period blood too. Check out my free nutrient-dense, anti-inflammatory recipes if you’re struggling in this department.

What about texture?

When your period is heaviest, you may experience some blood clots. This can be completely normal or indicative of a hormone imbalance or nutrient deficiencies. 

Clots larger than a quarter are not normal. Something the size of a raisin would not be a concern.

If you feel the blood between two fingers and it’s sticky or tacky — and especially if it’s accompanied by fever and/or pelvic pain — it’s quite possible there’s an infection going on and you should contact your doctor.

A strong odor can also be a sign that something’s just not right. If your period blood has a fishy, foul odor to it…it may be time to head to the physician’s office to get things checked out, just in case. 

I’m bleeding in the middle of my cycle, should I be worried?

No matter the color or consistency, if you’re bleeding and it’s not the time for your period, it’s best to contact your physician to make sure nothing out of the ordinary is going on.

Bleeding in the middle of your cycle can possibly indicate one of the following:

  • Normal spotting caused by ovulation
  • Implantation (pregnancy)
  • Uterine fibroids
  • Polyps
  • Cervical cancer
  • Sexually transmitted infections
  • Endometriosis
  • Miscarriage
  • Pelvic inflammatory disease

When should I see a doctor?

Ladies, you cannot diagnose a hormone imbalance, infection, or any other medical condition by period blood color alone. It is one piece of data that needs to be considered and then lab testing needs to follow with a competent and licensed provider.

If you’re concerned about an abnormal color to your period blood and/or are experiencing any of the following symptoms, best to call your doctor and get things checked out:

  • If you’re pregnant and bleeding
  • Yellow or green vaginal discharge
  • Severe stabbing pains
  • Unusually heavy bleeding
  • Fever
  • Bleeding for more than 7 days

Remember, it’s about bio-individuality

As with all matters of female reproductive health, there tends to be a staggering lack of reliable information available regarding period blood and normal colors — simply because we’ve been told for so long not to openly discuss these kinds of things and ask questions.

What’s normal for you may not be normal for another woman, and that’s OK! Just don’t be afraid to ask and talk about what you’re experiencing.

Grab a copy of Beyond the Pill so I can teach you everything you’ve never been taught about your hormones and how to keep them in tip-top shape.  Right now, we’re offering $250 in bonus resources and recipes you do not want to miss!

And head over to Instagram where no female health subject is off limits! Join us in the discussion!

Resources

https://my.clevelandclinic.org/health/articles/10132-normal-menstruation

https://my.clevelandclinic.org/health/articles/9709-pregnancy-am-i-pregnant

https://my.clevelandclinic.org/health/diseases/9130-uterine-fibroids

https://my.clevelandclinic.org/health/diseases/9138-sexually-transmitted-diseases–infections-std–sti

https://my.clevelandclinic.org/health/diseases/16856-cervical-cancer-cancer-institute-overview

https://my.clevelandclinic.org/health/diseases/3963-bacterial-vaginosis

https://my.clevelandclinic.org/health/diseases/9129-pelvic-inflammatory-disease-pid

https://www.ncbi.nlm.nih.gov/pubmed/22350580

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4594618/

https://www.ncbi.nlm.nih.gov/pubmed/19252193

https://www.bmj.com/content/335/7623/765

https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Gynecologic-Practice/Management-of-Acute-Abnormal-Uterine-Bleeding-in-Nonpregnant-Reproductive-Aged-Women

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About The Author

Dr. Jolene Brighten

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Dr. Jolene Brighten, NMD, is one of the leading experts in women’s medicine and is a pioneer in her exploration of the far-reaching impact of hormonal birth control and the little known side effects that impact health in a large way. In her best selling book, Beyond the Pill, she shares her clinical protocols aimed at supporting women struggling with symptoms of hormone imbalance, including Post-Birth Control Pill Syndrome and birth control related side effects. A trained nutritional biochemist and Naturopathic Physician, Dr. Brighten is the founder and Clinic Director at Rubus Health, an integrative women’s medicine clinic. She is a member of the MindBodyGreen Collective and has been featured in prominent media outlets such as Forbes, Cosmopolitan, ABC news, and the New York Post. Read more about me here.