Discharge before a period is a relatively common finding, and typically presents as white, odorless and slightly elastic and slippery. This discharge normally appears due to hormonal changes during the menstrual cycle and is commonly noted after ovulation.

However, if the discharge has a different color or has other abnormal characteristics such as a foul odor or thick consistency, or if it presents with other symptoms such as pain, burning, itching, pain or bleeding during sex, or vulvar irritation, it could be a sign of infection.

It is important to consult a gynecologist if you notice abnornal discharge before a period, especially if is accompanied by other symptoms. The doctor will assess the discharge and symptoms and order tests as needed to determine a diagnosis and start treatment if needed.

What causes discharge before a period?

The main causes of discharge before a period are:

1. Ovulation

The ovulation phase of the menstrual cycle generally begins around day 14 of the menstrual cycle. It is normal for women who do not use contraceptives to experience a thin, transparent discharge, similar to egg whites.

At this stage of the menstrual cycle, there is an increase in estrogen levels, which triggers the body to produce more luteinizing hormone (LH). This hormone is responsible for releasing the more mature egg, forcing it to leave the ovary.

What to do: Clear and thin discharge is normal during ovulation in women who are not taking contraceptives. No treatment is necessary for this discharge, especially if it does not present with any other symptoms. Sex during this period is associated with a higher likelihood of fertilization and pregnancy. Learn more about the other ovulation symptoms that may occur during this phase.

2. Luteal phase of the menstrual cycle

The luteal phase of the menstrual cycle begins with the release of the egg from a follicle, which then seals off and forms the corpus luteum. This mass of cells triggers an increased production of progesterone, which prepares the lining of the uterus for the event of a possible pregnancy.

In this phase, which occurs, on average, in the last 12 days of the cycle, it is normal for women to experience a white discharge that has no odor, called leukorrhoea. This discharge is made up mainly of leukocytes.

What to do: This type of discharge before a period is normal. However, if it has a foul odor, is thick or is accompanied by vainal itching, pain or irritation, it could be a type of infection that should be evaluated by a doctor.

3. Pregnancy

One of the most common symptoms that may appear at the beginning of pregnancy is the presence of discharge or scant bleeding. These appear in the first 15 days after conception due to the implantation of the embryo in the endometrium. Discharge tends to be pink or brown, and lasts for about 2 to 3 days. It can cause cramps similar to those of menstruation. Read more about implantation symptoms and how they can present.

What to do: Unprotected sex during the ovulation phase that is followed by a pink or brown discharge before a period may be a sign of pregnancy. You can take a home pregnancy test to confirm or rule out pregnancy, and see your doctor if it is positive.

4. Hormonal imbalances

Hormonal imbalances can occur when starting or changing contraceptives, or with ovarian cysts or pre-menopause. It can lead to the appearance of a pink discharge before a period.

This happens because, in these cases, a period can start earlier than expected, causing menstrual blood to mix with the normal white discharge, leading to a more pinkish discharge.

What to do: If the pink discharge appears with other symptoms such as pain during sex, bleeding or pelvic pain, it may be a sign of infection. In these cases, you are advised to consult a gynecologist to identify the underlying cause and initiate treatment as necessary.

5. Yeast infection

A yeast infection is an infection caused by Candida albicans fungus. This fungus is naturally found in the genital region, but overgrowth can lead to white or yellow cottage cheese-like discharge and other symptoms like intense vaginal itching, redness and vulvar swelling, and burning when urinating.

This type of infection is quite common, and can appear at any stage of the menstrual cycle due to hormonal changes. It can also develop due to the use of contraceptives containing estrogen, diabetes or even the use of antibiotics, which can lead to an imbalance of the microbiota vaginal and promote fungal growth.

What to do: Treatment of a yeast infection should be directed by a doctor, who may prescribe antifungal medications, such as miconazole, tioconazole, nystatin, fluconazole or itraconazole. These medications can be prescribed in the form of ointments, creams, vaginal ovules or tablets.

6. Bacterial vaginosis

Bacterial vaginosis is a vaginal infection that is normally caused by Gardnerella sp. bacteria. It leads to the appearance of white or grayish vaginal discharge, with a pasty consistency and a strong, unpleasant smell, similar to rotten fish. Symptoms and the odor can worsen during sex or a period.

This type of infection can cause other symptoms such as external vaginal itching, burning or discomfort when urinating.

What to do: It is important to see a family doctor or gynecologist if you experience any of the above symptoms. Treatment for bacterial vaginosis generally involves the use of oral or topical antibiotics, such as metronidazole or clindamycin, which should be used for the duration established by the doctor. Leaving bacterial vaginosis untreated can increase your risk of getting a sexually transmitted infection or pelvic inflammatory disease.

7. Cervicitis

Cervicitis is an inflammation of the cervix, that causes symptoms such as gray, white or yellow vaginal discharge. This discharge can appear before a period or at any stage of the menstrual cycle. Cervicitis may also cause bleeding outside of a period, bleeding during sex, pain during urination or sex, pelvic pain or vulvar irritation.

Cervicitis is most often caused by sexually transmitted infections, such as gonorrhea, chlamydia or trichomoniasis, but it can also occur with allergies to menstrual pads to tampons or hormonal imbalances.

What to do: You should consult a gynecologist who will recommend treatment that is targeted at treating the underlying cause of the cervicitis. He or she may prescribe antibiotics or antifungals for example, and recommend avoiding products that may trigger irritation. During treatment, you should avoid having sex, and all sexual partners are encouraged to seek assessment to rule out the possibility of an infection.

8. Use of contraceptives

The use of contraceptives, especially those that contain only progesterone, can cause brown discharge or small breakthrough bleeding, called spotting, before menstruation. This is more common to occur in the first months of contraceptive use, as the body adapts to it.

What to do: This type of discharge generally improves a few months after starting treatment with contraceptives. However, brown discharge after unprotected sex with pain or burning may be a sign of an STI, like gonorrhea, which should be treated as directed by a doctor. Read more about how gonorrhea treatment and what your doctor may recommend.

9. Trichomoniasis

Trichomoniasis is an STI that can cause green discharge before a period and is usually accompanied by an unpleasant smell, itching and burning in the vaginal area.

In addition to trichomoniasis, this type of green discharge can be caused by other sexually transmitted infections, such as chlamydia or gonorrhea.

What to do: You are advised to see your doctor if you notice green discharge as it typically requires further treatment..

10. Pelvic inflammatory disease

Pelvic inflammatory disease (PID) is an inflammation that originates in the vagina and progresses toward the uterus, fallopian tubes and ovaries, until it spreads over the pelvic area. It is associated with symptoms like a yellow or green discharge with a foul smell, a fever above 38ºC (or 100.4ºF), abdominal pain and vaginal bleeding. Learn more about what can cause yellow discharge and how it is treated.

In most cases, pelvic inflammatory disease occurs as a result of an untreated STI, but it can also develop due a post-partum pelvic infection, endometriosis, or introducing contaminated objects into the vagina when masturbating.

What to do: Treatment of pelvic inflammatory disease involves the use of prescribed antibiotics, such as azithromycin, levofloxacin or clindamycin. These can be prescribed in tablet or injection form. During treatment, sex should also be avoided to promote optimal recovery.

When to see a doctor

It is important to consult a gynecologist when:

The discharge has a foul odor
Other symptoms appear, such as vaginal pain, irritation when urinating, or discomfort during sex
Your period is more than 2 months late

You are advised to consult a gynecologist regularly, at least once a year, to carry out preventive diagnostic tests, such as a pap smear.