Breakthrough Bleeding on Birth Control Pills: What to Do Next?

Bleeding after taking emergency contraceptive pills?

If you have been taking the 21-day oral contraceptive pill (Mireille) and you have only three pills left but have started experiencing bleeding symptoms that resemble the first day of your period, which is a coffee-red color, you should finish taking the remaining pills.
The day after you stop taking the pills is considered the first day of your menstrual cycle.
You should start the next pack of oral contraceptive pills on the same day you would normally start your new pack, which is typically after a 7-day break.
This ensures that you maintain effective contraception.

Xxx, 20~29 year old female. Ask Date: 2016/03/25

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, start taking the contraceptive pill on the fifth day of your menstrual period, and then observe if your period comes early next month.
If it does, you may consider switching to another type of contraceptive pill.
Wishing you good health.

Reply Date: 2016/03/25

More Info

Breakthrough bleeding while on birth control pills, such as the 21-day regimen you mentioned (like Marvelon), can be a common occurrence. This type of bleeding is typically lighter than a regular menstrual period and can happen for various reasons, including hormonal fluctuations, missed doses, or the body adjusting to the hormones in the pills.
When you experience breakthrough bleeding, it is essential to understand how to manage it and what steps to take next. First, it is crucial to continue taking your birth control pills as prescribed, even if you experience bleeding. Stopping the pills abruptly can lead to further hormonal imbalance and may increase the risk of unintended pregnancy.
In your case, since you are nearing the end of your pill pack, you should complete the remaining pills as scheduled. After finishing the pack, you will typically have a withdrawal bleed (similar to a period) during the placebo week or the week when you do not take any pills. This withdrawal bleed is a result of the sudden drop in hormone levels when you stop taking the active pills.
To answer your question about counting the first day of your cycle: the first day of your withdrawal bleed (the day you notice bleeding) is considered Day 1 of your new cycle. You should start your next pack of birth control pills the day after you finish the placebo pills or the last active pill, regardless of whether you are still bleeding or not.
If the breakthrough bleeding continues or becomes heavy, it is advisable to consult with your healthcare provider. They may want to evaluate whether the current birth control method is suitable for you or if an adjustment in dosage or a different formulation might be necessary.
Additionally, if you have missed any pills during your cycle, this could contribute to breakthrough bleeding. It is essential to take your pills consistently at the same time each day to maintain hormone levels and prevent such occurrences. If you miss a pill, follow the instructions provided with your medication regarding what to do next, which typically involves taking the missed pill as soon as you remember and continuing with the rest of the pack as scheduled.

In summary, continue taking your pills as directed, consider the first day of your withdrawal bleed as Day 1 of your new cycle, and start your next pack on schedule. If you have concerns about the bleeding or experience any other unusual symptoms, reach out to your healthcare provider for further guidance. They can provide personalized advice based on your medical history and current situation.

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Hello, you need to continue taking the contraceptive pills. Wishing you good health.