Irregular Periods: Should You Continue Birth Control Pills?

Menstruation has stopped after taking birth control pills?

Hello Doctor, I have been experiencing irregular menstruation (I have a particularly long period every 2 to 3 cycles, lasting over 10 days, and then it comes again after two weeks).
Last week, I consulted a gynecologist who decided to prescribe me Yaz as a menstrual regulation medication.
I had taken this medication for the same purpose about 2 to 3 years ago.
This time, my period was delayed by 3 to 4 days before it started.
I began taking the medication as soon as I confirmed bleeding on the first day, but my period only lasted for two days, and it was very light.
By the third day, there was hardly any blood on my panty liner.
I am worried that this might just be light spotting and not a true menstrual period, which would mean the medication is ineffective.
Should I continue taking it? I would like to ask the doctor about my previous visit where I had an ultrasound and a pelvic exam.
The doctor mentioned that my cervix was normal, but the ultrasound indicated that I have polycystic ovary syndrome (PCOS).
I hope the doctor can clarify whether this is a normal situation and whether I should continue taking the menstrual regulation medication or wait for my next period to buy another pack.
Thank you, Doctor.

Xiao Ting, 20~29 year old female. Ask Date: 2020/03/14

Dr. Wu Xianghui reply Obstetrics and Gynecology

There are many factors that can affect menstrual cycle irregularities.
A thorough evaluation including medical history, blood tests, and imaging studies is necessary to determine the underlying cause.
It is recommended to return to the original prescribing clinic or consult with a specialist in obstetrics and gynecology for assessment.

Reply Date: 2020/03/14

More Info

When dealing with irregular menstrual cycles, especially in the context of polycystic ovary syndrome (PCOS), it is essential to understand the implications of continuing or discontinuing birth control pills like Yaz (drospirenone and ethinyl estradiol). Your situation, characterized by prolonged and irregular periods, is not uncommon among women with PCOS, which can lead to concerns about the effectiveness of treatment and the nature of your menstrual bleeding.

Firstly, it is important to recognize that birth control pills are often prescribed to help regulate menstrual cycles, manage symptoms associated with PCOS, and reduce the risk of endometrial hyperplasia due to prolonged unopposed estrogen exposure. Given that you have previously used Yaz successfully, it is reasonable to consider continuing this medication as part of your treatment plan. However, the irregularity of your current cycle, where you experienced a very light period lasting only two days, raises some questions.

1. Understanding Your Bleeding: The light bleeding you experienced could be a withdrawal bleed from the birth control pills rather than a true menstrual period. This is common when starting or adjusting hormonal contraceptives. If the bleeding is significantly lighter than your typical menstrual flow, it may indicate that your body is still adjusting to the medication. It is not unusual for women with PCOS to experience variations in their menstrual cycles, even while on birth control.

2. Continuing Birth Control Pills: It is generally advisable to continue taking the birth control pills as prescribed, even if your bleeding is lighter than expected. Stopping the medication prematurely could lead to further irregularities and may not allow your body to stabilize. Birth control pills can help regulate your cycle over time, and it may take a few months for your body to respond fully.

3. Monitoring Your Symptoms: Keep track of your menstrual cycles, including the duration and flow of your periods, as well as any other symptoms you may experience. This information will be valuable for your healthcare provider in assessing the effectiveness of the treatment and making any necessary adjustments.

4. Consulting Your Healthcare Provider: Since you have already consulted with a gynecologist and undergone an ultrasound, it is crucial to maintain open communication with your healthcare provider. If you have concerns about the light bleeding or if your symptoms change, do not hesitate to reach out for further evaluation. Your doctor may recommend additional tests or a different treatment approach if necessary.

5. Lifestyle Considerations: In addition to medication, lifestyle modifications can play a significant role in managing PCOS. Regular exercise, a balanced diet, and maintaining a healthy weight can help improve insulin sensitivity and hormonal balance, which may contribute to more regular menstrual cycles.

In conclusion, while it is understandable to be concerned about the irregularity of your menstrual cycle and the light bleeding you experienced, it is generally advisable to continue taking your birth control pills as prescribed. Monitor your symptoms closely and maintain communication with your healthcare provider to ensure that your treatment plan is effective and appropriate for your needs. If you have any further questions or concerns, do not hesitate to seek additional medical advice.

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