Prolonged Bleeding: Is It Your Menstrual Cycle?

Persistent bleeding

Hello Doctor, I am #144535.
I experienced bleeding due to taking birth control pills, which started on the 6th and continued until the 18th.
On the evening of the 18th, I visited a doctor, and the amount of bleeding that day was very minimal, consisting of brown discharge.
The doctor examined me and said that my uterus was very clean, indicating that the endometrium had completely shed, meaning the bleeding had finished.
I asked if I needed to take progesterone, and he said no.
He advised me to stop taking the Yuzhi birth control pills and to wait until my next menstrual period arrives before starting them again.
However, he mentioned that there might be a small amount of bleeding in between.

After returning home, I did not experience any bleeding for the first two days, but on the 21st, I started bleeding again and it has continued until today, the 23rd, with a greater volume than the bleeding from the 6th to the 18th.
I am also experiencing abdominal pain.
Is this my menstrual period? Which bleeding, the one from the 6th to the 18th or the one starting on the 21st, is my actual menstrual period? Can I continue taking the birth control pills, or should I follow the doctor's advice and wait for my next period to start taking them? If I can take the Yuzhi birth control pills, can I start taking the first pill on the evening of the 24th?

Niming, 10~19 year old female. Ask Date: 2019/03/23

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I experienced bleeding after taking birth control pills, starting from the 6th and continuing until the 18th.
On the evening of the 18th, I visited a doctor, and the amount of blood that day was very minimal, consisting of brown discharge.
The doctor examined me and said that my uterus was very clean, indicating that the endometrium had completely shed, which meant the bleeding had finished.
I asked if I needed to take progesterone, and he said no.
He advised me to stop taking the Yuzhi birth control pills and to wait until my next menstrual period arrives before starting them again.
However, he mentioned that there might be a small amount of bleeding in between.
After returning home, I did not experience any bleeding for the first two days, but on the 21st, I started bleeding again and it has continued until today, the 23rd, with a greater volume than the bleeding from the 6th to the 18th, accompanied by abdominal pain.

Is this my menstrual period? Which bleeding, the one from the 6th to the 18th or the one starting on the 21st, is my actual menstruation? Can I continue taking birth control pills with the bleeding starting on the 21st? Should I follow the doctor's advice and wait until my next period to start taking them? If I can take the Yuzhi birth control pills, can I start taking the first pill on the evening of the 24th?
Yes, you can start taking the pills on the 24th.

Reply Date: 2019/03/23

More Info

Understanding prolonged bleeding, especially in the context of hormonal contraceptive use, can be complex. Based on your description, it seems you experienced a prolonged episode of bleeding from the 6th to the 18th, which was characterized by a small amount of coffee-colored discharge. After consulting with your doctor, you were informed that your uterus was clear and that the endometrial lining had shed completely. This suggests that the bleeding you experienced during that time was likely a result of hormonal fluctuations due to the contraceptive pill.

Now, regarding the bleeding that started again on the 21st and has continued, it is essential to differentiate between what could be considered your actual menstrual period and any irregular bleeding that may occur due to hormonal adjustments. The bleeding you experienced from the 6th to the 18th may have been a withdrawal bleed or breakthrough bleeding, which is common when starting or stopping hormonal contraceptives. The bleeding that began on the 21st, which is heavier and accompanied by abdominal pain, is more likely to be your actual menstrual period, especially if it aligns with the typical timing of your cycle.

When it comes to continuing the use of your contraceptive pill, it is generally advisable to follow your doctor's instructions. Since your doctor recommended that you stop taking the pill until your next natural period, it would be wise to adhere to that advice. Starting the pill again while experiencing what seems to be a menstrual period could lead to further confusion regarding your cycle and may not be effective in regulating your bleeding.

If you decide to resume taking the contraceptive pill, it is typically recommended to start it on the first day of your next menstrual cycle. This helps to ensure that the hormonal levels are appropriately adjusted and can provide better cycle regulation. If you are considering starting the pill on the 24th while still bleeding, it is best to consult your healthcare provider for personalized advice.

In summary, the bleeding you are experiencing now is likely your menstrual period, and it is advisable to wait until your next cycle to resume taking the contraceptive pill as per your doctor's guidance. If you have concerns about the amount of bleeding, the duration, or any accompanying symptoms like severe abdominal pain, it is crucial to follow up with your healthcare provider for further evaluation. They can help determine if any additional treatment or investigation is necessary to ensure your reproductive health is managed effectively.

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