Breakthrough Bleeding and Effectiveness of YAZ Birth Control

Prolonged bleeding with emergency contraceptive pills & effectiveness?

Hello Dr.
Chang, this is my first time taking YAZ oral contraceptive.
I started taking it on the first day of my period (January 21) as instructed, consistently taking it every night between 10 and 11 PM, and I am sure I did not miss any doses.
On the 12th day after starting (February 1), I had unprotected intercourse.
Around February 8, I began experiencing breast tenderness (which I usually have before my period).
On February 11, with three pink active pills remaining, I started having bleeding similar to my period, which came about 10 days earlier than usual (my periods are usually regular, typically starting after the 20th of the month).
After taking the last white inactive pill on February 17, by February 18, my period seemed to have ended (I used a menstrual cup and confirmed it was clean), and I did not continue with the next pack.
However, on February 19, I suddenly had bleeding again, although it was light, I am a bit worried since this means I have been bleeding for 9 days.
My questions are as follows:
1.
Regarding the unprotected intercourse on February 1, after taking the contraceptive for 11 days and subsequently experiencing bleeding, is the likelihood of pregnancy effectively zero? Is there a need for a pregnancy test?
2.
I have been bleeding for 9 days (very light).
If this continues, how many days of bleeding would be considered abnormal and warrant seeing a doctor? (As I am currently abroad, seeing a doctor is not very convenient.)
3.
I am certain that I will not engage in any risky sexual behavior moving forward.
I initially planned not to continue with the next pack, but I am unsure if stopping after just one pack has caused the prolonged bleeding.
Would you recommend that I continue taking the oral contraceptive to regulate my period before stopping? Thank you for your guidance!

Miss Lin, 20~29 year old female. Ask Date: 2019/02/19

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the oral contraceptive pill must be taken consistently every day at the same time to be effective, especially during the first 12 days of use, as missing a dose can reduce its contraceptive effectiveness.
If you are concerned about potential contraceptive failure, you may use a test strip to check according to the correct method.
During the usage period, if you experience menstruation or bleeding, you do not need to stop taking the pill; continue to take it as scheduled.
Once your body adjusts to the contraceptive, abnormal bleeding should cease.
However, if irregular bleeding persists for more than three months or if you experience heavy bleeding, you should consult a physician for advice.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2019/02/19

More Info

Understanding breakthrough bleeding while on birth control, such as YAZ, is a common concern among new users. YAZ is a combination oral contraceptive that contains drospirenone and ethinyl estradiol, which work together to prevent ovulation and regulate menstrual cycles. However, breakthrough bleeding can occur, especially during the initial months of use, as your body adjusts to the hormones.

1. Pregnancy Risk After Unprotected Intercourse: Given that you began taking YAZ on the first day of your menstrual cycle and had been consistent with your dosage for 11 days before the unprotected intercourse on February 1, the likelihood of pregnancy is quite low. YAZ is generally effective after seven consecutive days of use, meaning you were well-protected at the time of intercourse. The bleeding you experienced afterward could be attributed to breakthrough bleeding rather than a sign of pregnancy. However, if you have concerns or experience symptoms such as a missed period or unusual changes, taking a pregnancy test can provide peace of mind.

2. Duration of Breakthrough Bleeding: Breakthrough bleeding can last for varying lengths of time, but if you experience bleeding that continues for more than 7 days, it is advisable to consult a healthcare provider. While some spotting or light bleeding can be normal, prolonged bleeding may indicate a need for medical evaluation, especially if accompanied by other symptoms like severe pain or heavy bleeding.

3. Continuing Birth Control: If you are experiencing prolonged breakthrough bleeding, it may be beneficial to continue taking your birth control pills as prescribed. Stopping the pills can sometimes lead to irregular bleeding patterns. By continuing the medication, you may help stabilize your hormonal levels, which could reduce the occurrence of breakthrough bleeding. However, if the bleeding persists or worsens, it would be wise to consult a healthcare professional when possible.

In summary, while breakthrough bleeding can be concerning, it is often a normal side effect of starting a new contraceptive. Your adherence to the medication and the timing of your unprotected intercourse suggest a low risk of pregnancy. Monitoring the duration and nature of your bleeding is essential, and if it continues beyond a week, seeking medical advice would be prudent. Continuing with YAZ may help regulate your cycle, but if you have ongoing concerns, reaching out to a healthcare provider when feasible is the best course of action.

Similar Q&A

Understanding Breakthrough Bleeding with Birth Control Pills

Hello Doctor: I have been taking the Yaz contraceptive pill for nearly a year, and during this time, I have experienced almost no side effects. However, every two to three months, I notice vaginal bleeding about a week before taking the placebo pills (I take the pills at the same...

Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, if you are not experiencing any discomfort and it does not occur every month, you can continue taking it. Wishing you good health.

Understanding Breakthrough Bleeding While on Birth Control Pills

Hello Doctor, I would like to ask you about something. I have been taking Yaz for two and a half years, and I did not experience any side effects during the first two years. However, this month, during my ovulation period, I noticed some spotting. I remember that while on the med...

Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, please monitor the situation for now. If this condition persists next month, then consult an obstetrician-gynecologist. Wishing you good health.

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

Hello Doctor, I have been taking the contraceptive pill, YAZ, for about 8 months (without any bleeding or other side effects). Recently, I have started a new pack and have been taking it for 12 days, during which I experienced vaginal bleeding that lasted for two days (it was ver...

Dr. Cao Guotao reply Obstetrics and Gynecology
Hello, please continue to take the medication until completion. There is still contraceptive effectiveness during the bleeding period. We will observe next month. Wishing you good health.

Understanding Breakthrough Bleeding While Taking Emergency Contraceptive Pills

Hello doctor, I started taking Yaz 28 tablets at the end of May, but I didn't begin on the fifth day of my menstrual cycle; instead, I started taking it when my period hadn't arrived yet! This has resulted in a delayed period. However, today when I took the last active ...

Dr. Huang Zifei reply Obstetrics and Gynecology
Dear Youyou, If you are experiencing vaginal bleeding and visit the obstetrics and gynecology department, a routine pelvic examination and ultrasound will typically be performed to identify the source of the bleeding. Based on the examination results, we will discuss the next s...