Breakthrough bleeding refers to any unscheduled bleeding that occurs even though you are using active birth control pills (or patches and rings). If the bleeding is light, there’s no reason to be worried. Breakthrough bleeding is quite common, especially during the first six months of using birth control, as your body is still adapting to the hormonal changes. It’s just an initial side effect of hormone-based contraceptives — in fact, it’s their most often seen side effect.
The intensity of the breakthrough bleeding can range from a light brownish looking discharge to bleeding the same volume of blood like during your regular menstrual cycle.
How can I stop breakthrough bleeding?
There’s nothing you can do but patiently wait for your body to get used to the active birth control ingredients. Just keep on taking the birth control as prescribed by your doctor, and the breakthrough bleeding usually will go away within two to three cycles. Even if you are bleeding again during the next cycle, it most likely will be less bleeding than during the current cycle.
If the breakthrough bleeding recurs for more than 2-3 cycles or becomes more intense, it’s recommended that you see your doctor to check whether there’s something else going on.
It’s also important to bear in mind that some medications can interact with the hormones of birth control pills. This can increase the risk of bleeding. Therefore, it’s important to tell your doctor about any new medications you are taking. Likewise, when a doctor prescribes new medications for you, you should ask whether they’ll interfere with birth control pills.
If the blood volume is heavy — such as filling one pad or tampon per hour for several consecutive hours — and if that’s accompanied by dizziness, you should seek medical help right away. Doctors will check whether the bleeding is related to your birth control use or if there are other causes.
Does skipping periods cause breakthrough bleeding?
For some women, breakthrough bleeding happens again, and again each time they want to skip periods. If the recurring breakthrough bleeding persists for longer than five months, talk to your doctor about putting you on a different birth control pill. There are many different options, and each pill is tolerated differently by different women. Sometimes it takes two or three trials to find the right pill.
It’s also a good idea to occasionally allow a period every 2 to 3 months by going off the hormones or using the inactive pills at the end of each pill pack. Such a break, which can last 4-7 days, will reduce the chances of getting breakthrough bleeding when you are on active pills.
Missed or late pills are another common reason for breakthrough bleeding.
Missed or late pills also can cause breakthrough bleeding, which is why it’s so important that you carefully stick to the prescribed birth control schedule, taking it at exact intervals and at the same time of the day. Not missing a pill not only prevents breakthrough bleeding, but it also ensures optimal pregnancy protection, which can be as high as 99% if the pill is taken correctly. You can remind yourself that you have to take the pill by setting alarms on your phone or combining the pill taking with a daily ritual, such as tooth brushing.
Is breakthrough bleeding more common with progestin-only pills?
Yes, taking progestin-only pills instead of combined pills makes it slightly more likely that you get irregular spotting and bleeding during the first three to six months of using birth control. However, you’ll notice a gradual improvement, and after six months, the breakthrough bleeding will have disappeared entirely. If you still experience bleeding beyond the sixth month of using progestin-only pills, there may be some other issues. It’s recommended to consult with your gynecologist or general doctor.
- Villavicencio, Jennifer, and Rebecca H Allen. “Unscheduled Bleeding and Contraceptive Choice: Increasing Satisfaction and Continuation Rates.” Open Access Journal of Contraception, vol. 7, 31 Mar. 2016, pp. 43–52, www.ncbi.nlm.nih.gov/pmc/articles/PMC5683158/, 10.2147/OAJC.S85565. Accessed 9 Jun 2020.
- Wright, Kristen Page, and Julia V Johnson. “Evaluation of Extended and Continuous Use Oral Contraceptives.” Therapeutics and Clinical Risk Management, vol. 4, no. 5, 2008, pp. 905–11, www.ncbi.nlm.nih.gov/pmc/articles/PMC2621397/. Accessed 9 Jun. 2020.