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Lochia serosa which persists to some weeks after birth can indicate late postpartum hemorrhaging, and should be reported to a physician. Lochia alba (or purulenta) is the name for lochia once it has turned whitish or yellowish-white. It typically lasts from the second through the third to sixth weeks after delivery.
After delivery, leukorrhea accompanied by backache and foul-smelling lochia (post-partum vaginal discharge, containing blood, mucus, and placental tissue) may suggest the failure of involution (the uterus returning to pre-pregnancy size) due to infection.
During pregnancy, vaginal discharge volume increases as a result of the body's increased levels of estrogen and progesterone. [13] [2] The discharge is usually white or slightly gray, and may have a musty smell. [13] [2] The normal discharge of pregnancy does not contain blood or cause itching. [13]
Hemorrhoids are common in pregnancy as a result of constipation and increased intra-abdominal pressure. Hemorrhoids can cause bleeding, pain, and itching. [31] Treatment is symptomatic, including improving underlying constipation. Symptoms may resolve spontaneously after pregnancy, although hemorrhoids may remain in the days after childbirth. [32]
After birth, the fundus contracts downward into the pelvis one centimeter each day. After two weeks the uterus will have contracted and return into the pelvis. [9] The sensation and strength of postpartum uterine contractions can be stronger in women who have previously delivered a child or children. [10]
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Women who have an anal tear are less likely to have resumed sex after six months [10] and one year, [11] but they have normal sexual function 18 months later. [12] Assisted vaginal delivery using suction or forceps is correlated with increases in the frequency or severity of painful sex, [8] the delay in resuming sex, and sexual problems. [13]
Nipple discharge in men is not normal. [3] Discharge from nipples is also more likely to be abnormal (pathological) if it is crystal clear or blood-stained, is from only one breast, or is associated with a breast lump, swelling, redness or overlying skin changes. [2] [3] [4] A blocked or enlarged milk duct can result in nipple discharge. [3]