Black Discharge: Causes, What It Means, & How to Treat

Healthy vaginal discharge is white or off-white and may sometimes be pink or red around the time of your period.[1] However, discharge in any other color—including black—is usually considered abnormal and may indicate the presence of an underlying health issue.[2]

Black discharge: causes, what it means, and how to treat—the answers to these questions are below. If you have abnormal discharge, don’t hesitate to make an appointment with your healthcare provider so you can find out what’s going on.

By Dr. Kenosha Gleaton

What Does Black Discharge Mean?

Iron becomes red when it is exposed to oxygen, which explains why blood is typically bright red.[3] As oxygen leaves your blood supply, your blood becomes darker in color.[3] Vaginal discharge that is dark or black in color is usually just blood that is taking a long time to leave your body.

Is Black Discharge Normal?

The best way to determine whether black discharge is a cause for concern is to see your healthcare provider. Your provider can perform testing to identify or rule out an infection and talk to you more about your symptoms and menstrual cycle. Dark-colored discharge may sometimes indicate irregular periods or pregnancy.[1]

If your healthcare provider finds that your black discharge is normal, These products may help regulate your menstrual cycle and prevent black discharge.

Causes of Black Discharge

Black discharge can be caused by a wide range of factors. Identifying the root cause of abnormal discharge can guide you toward finding the right treatment.

Retained Objects

In this context, a retained object refers to any object that has been left or forgotten about in your vagina. Such retained objects include tampons, menstrual cups, and toilet tissue.[2]

Retained objects may cause black discharge and a foul odor and increase your risk for infections and toxic shock syndrome—a serious complication that can lead to shock, kidney failure, and death.[2, 4]

PID or Sexually Transmitted Infections (STIs)

Pelvic inflammatory disease (PID) and STIs can lead to bleeding in one or more of your pelvic organs that comes out as black discharge.[5] In fact, PID is a common complication of STIs, including chlamydia and gonorrhea, which means you may want to be tested and evaluated for all these conditions if you have black discharge.[5]

If the abnormal discharge is being caused by PID or an STI, your symptoms may also include fever, irregular periods, abdominal pain, a burning sensation when urinating, and a foul odor from the vagina.[5]

Implantation Bleeding

As an early sign of pregnancy, implantation bleeding usually occurs six to 12 days after your egg is fertilized.[6] It may appear in your underwear in the form of dark-colored spotting that lasts for one to two days.[6] In addition to dark discharge, you may also experience headache, bloating, fatigue, and breast tenderness.[6]

Missed Miscarriage

A missed miscarriage is a type of miscarriage in which the embryo dies or never formed, but placental and embryonic tissues remain in the uterus.[7] Dark or black discharge is a possible symptom, along with vaginal bleeding, pelvic pain or cramping, and rapid heart rate.[8]

Postpartum Bleeding (Lochia)

Lochia lasts for up to six weeks after you give birth.[9] It usually begins as dark bleeding that gradually fades to white discharge over several weeks.[9] Sometimes, lochia will produce black discharge, along with dark blood clots and other tissues.[9]

Retained Menses (Hematocolpos)

Hematocolpos is a condition in which menstrual blood is retained in the vagina during puberty.[10] It is also known as retained menses.[10] The blood produced with retained menses may be dark or black due to oxygenation.

Cervical Cancer

Abnormal vaginal bleeding and unusual discharge—which may include black discharge—are common symptoms of cervical cancer.[11] Other symptoms of cervical cancer include[11]:

• Pain during intercourse
• Pelvic pain
• Swelling in the legs
• Problems with urinating or having bowel movements
• Bloody urine

Symptoms of cervical cancer typically don’t show up until the cancer is in its later stages.[11] See your healthcare provider right away if the black discharge is accompanied by any of the above symptoms.

When to See a Doctor

Black discharge isn’t always a serious concern, but getting it checked out can help you confirm whether it’s a sign of an underlying health problem. Make an appointment with your healthcare provider if you have any of the following symptoms in addition to black discharge[2]:

• Fever
• Pain in the stomach or pelvic area
• Sudden changes in your discharge
• Itching, redness, and swelling around the genitals
• Blisters or sores on the vagina
• Burning sensation when urinating

You should also see your provider if you think you have been exposed to an STI or if you think a particular medication is causing your symptoms.[2]

Treatment Options

Consult with your healthcare provider to learn about available treatment options if you experience black discharge regularly.

General Treatments

Treatment for black discharge will depend on the root cause of this symptom. For instance, no treatment may be needed if you experience it only during your monthly period or on an occasional basis.

Your provider can perform an exam and any other necessary testing to confirm or rule out underlying health conditions that may be causing black discharge. A proper diagnosis can guide both you and your provider toward choosing the right treatment. This may include practicing good vaginal hygiene and avoiding the use of tampons, menstrual discs, and menstrual cups.[2]

Specific Treatments

STIs can be effectively treated using antibiotics or antiviral medications.[12] If there is a retained object in your vagina, your provider can remove it using forceps or surgery, in extreme cases.[13]

If you have a miscarriage, your provider can perform an ultrasound to confirm that your body has passed all the fetal tissue on its own naturally.[14] If fetal tissue remains, you may need surgery or medication to have it fully removed and reduce the risk of infection.[14]

Retained menses and cervical cancer may require surgical intervention. The goal of surgery is to remove or repair tissues blocking the release of menstrual blood (retained menses) and to remove abnormal tissues and tumors (cervical cancer).[15] Your provider can discuss your surgical options for these conditions.

Practicing good menstrual hygiene may prevent you from experiencing black discharge. Steps you can take include[16]:

• Washing your hands before and after using menstrual products
• Disposing properly of used menstrual products according to the manufacturer’s directions
• Changing tampons every four to eight hours
• Changing maxi pads every few hours or more frequently for heavy flows
• Washing and sanitizing reusable menstrual products (such as period underwear and menstrual cups) according to the manufacturer’s instructions
• Wearing light, breathable underwear
• Keeping the genital area clean at all times
• Using unscented toilet tissue and feminine hygiene products
• Drinking plenty of fluids throughout the day

Schedule a visit with your healthcare provider every year.[17] During these visits, your provider can perform a full checkup, perform routine screenings for cervical cancer and STIs, and discuss ways to reduce your risk for disease and infection.[17]

STI testing recommendations usually depend on your age and symptoms.[18] For instance, all adults and teens between the ages of 13 and 64 should be tested at least once for HIV.[18] Your provider can discuss STI testing with you in more detail during your appointments.

Support for The Journey Ahead

At Natalist, we are devoted to helping you improve your reproductive health and offer a variety of vitamins, supplements, and other self-care products that can support you along the way! If you’re tracking your cycle, check out our Cycle Support Bundle, which includes vitamin D3, inositol, and an ovulation test kit. You can also try our doctor-formulated TTC Gummy Bundle or our Postpartum Essentials Bundle.

References

1. Vaginal Discharge. Cleveland Clinic. July 22, 2022. https://my.clevelandclinic.org/health/symptoms/4719-vaginal-discharge
2. Vaginal itching and discharge - adult and adolescent. National Institutes of Health. August 23, 2023. https://medlineplus.gov/ency/article/003158.htm
3. What Color Is Your Blood? Cleveland Clinic. May 4, 2022. https://health.clevelandclinic.org/what-color-is-blood
4. Toxic Shock Syndrome-Symptoms & Causes. Mayo Clinic. March 23, 20220. https://www.mayoclinic.org/diseases-conditions/toxic-shock-syndrome/symptoms-causes/syc-20355384
5. Pelvic Inflammatory Disease (PID) – CDC Basic Fact Sheet. CDC. April 18, 2022. https://www.cdc.gov/std/pid/stdfact-pid.htm
6. Implantation Bleeding. Cleveland Clinic. December 16, 2022. https://my.clevelandclinic.org/health/symptoms/24536-implantation-bleeding
7. Miscarriage-Diagnosis & Treatment. Mayo Clinic. September 8, 2023. https://www.mayoclinic.org/diseases-conditions/pregnancy-loss-miscarriage/diagnosis-treatment/drc-20354304
8. Miscarriage-Symptoms & Causes. Mayo Clinic. September 8, 2023. https://www.mayoclinic.org/diseases-conditions/pregnancy-loss-miscarriage/symptoms-causes/syc-20354298
9. Lochia. Cleveland Clinic. March 11, 2022. https://my.clevelandclinic.org/health/symptoms/22485-lochia
10. Jason M, Capelle X, Raquet J, Kridelka F. [Hematocolpos : an unappreciated diagnosis of hymen imperforation]. Revue Medicale De Liege. 2017;72(11):478-481. November 2017. https://pubmed.ncbi.nlm.nih.gov/29171945/
11. Signs and Symptoms of Cervical Cancer. American Cancer Society. January 3, 2020. https://www.cancer.org/cancer/types/cervical-cancer/detection-diagnosis-staging/signs-symptoms.html
12. Sexually Transmitted Infections. Cleveland Clinic. February 3, 2023. https://my.clevelandclinic.org/health/diseases/9138-sexually-transmitted-diseases--infections-stds--stis
13. ‌Anderson J, Paterek E. Vaginal Foreign Body Evaluation and Treatment. National Institutes of Health. May 8, 2023. https://www.ncbi.nlm.nih.gov/books/NBK549794/
14. Miscarriage. Cleveland Clinic. July 19, 2022. https://my.clevelandclinic.org/health/diseases/9688-miscarriage
15. ‌How Is Cervical Cancer Diagnosed and Treated? CDC. August 21, 2023. https://www.cdc.gov/cancer/cervical/basic_info/diagnosis_treatment.htm
16. Menstrual Hygiene. CDC. May 26, 2023. https://www.cdc.gov/hygiene/personal-hygiene/menstrual.html
17. Get Your Well-Woman Visit Every Year. U.S. Department of Health and Human Services. February 17, 2024. https://health.gov/myhealthfinder/healthy-living/sexual-health/get-your-well-woman-visit-every-year
18. Which STD Tests Should I Get? CDC. December 14, 2021. https://www.cdc.gov/std/prevention/screeningreccs.htm