Vaginal discharge is a normal and continuously produced fluid that maintains the health of the reproductive tract. This natural fluid is a complex mix of mucus from the cervix, secretions from glands, water, and beneficial bacteria that help clean and protect the vagina. Normal discharge typically appears clear, white, or off-white and may vary in consistency throughout the menstrual cycle. While color changes like light pink or brown are common, indicating small amounts of fresh or older blood, the appearance of purple discharge is highly unusual and suggests an underlying medical issue. Any instance of purple discharge warrants a medical evaluation, as it is not considered a typical physiological variation.
Understanding the Color Spectrum in Discharge
The color of vaginal discharge is primarily determined by its composition and the age of any blood content. Fresh bleeding is bright red because the hemoglobin in the blood is fully oxygenated. As blood remains in the body and is exposed to air, a process called oxidation occurs, causing the iron in the blood to darken. This gradual oxidation is why old blood often appears brown or very dark red, especially toward the end of a menstrual cycle.
A purple or nearly black discharge indicates an extreme concentration of old, unoxygenated blood or tissue retained within the reproductive tract for a prolonged period. This darkness suggests the blood has taken a significant amount of time to exit the uterus and vagina, allowing for maximum oxidation. The deep, purplish-maroon color is essentially an intensified version of the dark brown or black discharge that can occur when blood is delayed. The thickness and slow movement of this material contribute to the color shift, which is why it is often associated with conditions that physically impede flow.
Specific Conditions Leading to Purple Discharge
The dark, purple discharge often signals a condition where blood or tissue is trapped or poorly expelled from the uterus.
Retained Products of Conception (RPOC)
One cause is retained products of conception (RPOC), which is fetal or placental tissue remaining in the uterus after a miscarriage, abortion, or delivery. This retained tissue prevents the timely shedding of the uterine lining and blood, leading to heavy, prolonged bleeding. The resulting discharge is often dark and foul-smelling, and the foreign material can also cause infection.
Pelvic Inflammatory Disease (PID)
Another possibility is a severe, chronic infection like advanced Pelvic Inflammatory Disease (PID), which affects the reproductive organs. While PID typically causes yellow or green discharge, severe or long-standing cases can involve inflammation and scarring. This leads to trapped, old blood that appears extremely dark. The trapped fluid may be mixed with pus and infectious material, deepening the color to a maroon or black hue perceived as purple. PID requires prompt treatment to prevent long-term complications like chronic pelvic pain and infertility.
Polyps and Necrotic Tissue
In rarer instances, the dark discharge can be a sign of heavily bleeding, clotting cervical or uterine polyps or necrotic (dead or dying) tissue. Polyps are noncancerous growths that can bleed significantly; if this blood clots and exits slowly, it presents as a very dark discharge. Necrotic tissue, associated with extreme lack of oxygen or blood supply, causes an intensely dark, purplish coloration due to tissue breakdown and stagnant blood. These conditions require clinical tools like ultrasound and physical examination for accurate diagnosis.
Accompanying Symptoms That Require Urgent Care
When purple discharge is present, certain accompanying symptoms indicate a need for immediate medical attention.
- A high fever, typically above 101°F, especially when combined with chills, suggests a serious, spreading infection.
- Severe, sudden abdominal or pelvic pain not relieved by over-the-counter medication, which may signal acute complications like a pelvic abscess or severe inflammation.
- Signs of systemic illness, such as persistent vomiting, dizziness, or fainting, indicating severe infection or significant blood loss.
- Discharge heavy enough to soak through a menstrual pad within an hour, or if it has a strong, foul, or putrid odor.
These combinations of symptoms demand immediate consultation with a healthcare provider or a trip to an emergency room for rapid diagnosis and treatment.