Birth Control Pills: Menstrual Irregularities and Pregnancy Risks

Regarding pregnancy and contraceptive pills?

1.
I finished the first pack of 21-day oral contraceptive pills on January 21, but I experienced bleeding on January 20.
I'm not sure if it was my period, but the flow was heavy and bright red, and it continued until January 28.
Why is this happening? Typically, shouldn't I expect my period to occur within seven days after finishing the first pack of pills?
2.
I started taking the second pack of contraceptive pills four days after the bleeding began on January 20, and I am still taking them.
I had unprotected intercourse on January 27.
Is there a risk of pregnancy?
3.
If I frequently experience bleeding after sexual intercourse, is this considered abnormal?

Ning, 20~29 year old female. Ask Date: 2018/01/28

Dr. Huang Jianzhong reply Obstetrics and Gynecology

1.
I finished the first pack of 21-day oral contraceptives on January 21, but I experienced bleeding on January 20.
I'm not sure if it's my period, but the flow was heavy and red, and it continued until January 28.
Why is this happening? Generally, isn't it expected to have a period within seven days after finishing the first pack of contraceptives? Answer: Theoretically, menstruation should occur within seven days after finishing the contraceptive pack, but in reality, there can be variations.
2.
I started taking the second pack of contraceptives four days after the bleeding on January 20, and I am still taking them.
I had unprotected intercourse on January 27.
Is there a risk of pregnancy? Answer: There is no risk of pregnancy in this case.
3.
If I frequently experience bleeding after intercourse, is this considered abnormal? Answer: A Pap smear examination is necessary.

Reply Date: 2018/01/28

More Info

Understanding birth control pills and their effects on menstrual cycles can be quite complex, especially when considering the nuances of individual health and the hormonal changes that occur during their use. Let's break down your questions regarding the irregularities you are experiencing and the potential risks of pregnancy.

1. Menstrual Irregularities with Birth Control Pills: It is not uncommon for women to experience irregular bleeding or spotting when they first start taking birth control pills. This can happen for several reasons, including hormonal adjustments as your body adapts to the synthetic hormones in the pills. The bleeding you experienced on January 20th, which lasted until January 28th, could be a side effect of starting the pill, often referred to as "breakthrough bleeding." Typically, during the first month of taking the pill, your body may not have fully adjusted to the hormones, leading to unexpected bleeding.
Generally, after completing the first pack of 21 pills, many women will have a withdrawal bleed (similar to a period) during the placebo week (the last 7 days of the pack). However, this can vary, and some women may experience bleeding at different times or may not have a withdrawal bleed at all. If the bleeding is heavy or accompanied by severe pain, it is advisable to consult a healthcare provider.

2. Risk of Pregnancy: Regarding your second question, since you started your second pack of pills four days after the bleeding began, you should be protected from pregnancy if you have taken the pills consistently and correctly. Birth control pills are designed to prevent ovulation, and if taken as directed, they are highly effective. However, if you had unprotected intercourse on January 27th, it is essential to consider that the effectiveness of the pill can be compromised if you missed any doses or if you are experiencing significant breakthrough bleeding. If you are concerned about the possibility of pregnancy, you may want to take a home pregnancy test if your next period is late or consult with your healthcare provider for further guidance.

3. Post-Sexual Intercourse Bleeding: Experiencing bleeding after sexual intercourse can be concerning and may indicate an underlying issue. This could be due to several factors, including cervical irritation, infections, or hormonal changes caused by the birth control pills. If this bleeding occurs frequently or is accompanied by pain, it is important to seek medical advice. Your healthcare provider may perform an examination to rule out any potential issues, such as cervical polyps or infections, and provide appropriate treatment if necessary.

In summary, while irregular bleeding can be a common side effect of starting birth control pills, it is essential to monitor your symptoms and consult with a healthcare provider if you have concerns about your menstrual cycle or the risk of pregnancy. Consistent and correct use of birth control pills is crucial for their effectiveness, and any unusual symptoms should be discussed with a medical professional to ensure your reproductive health is managed appropriately.

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