Unscheduled Bleeding on Birth Control: Am I Pregnant?

Can I get pregnant?

Hello doctor, I have been taking Diane for five months now.
During sexual intercourse, I always use condoms and check for any leakage afterward.
However, this month, around the 17th or 18th day of taking Diane, I noticed some bleeding.
Although it wasn't much and sometimes very light, I immediately went to the clinic to see a doctor.
I have also been dealing with a urinary tract infection and have been on antibiotics for over a week.
The doctor performed a pelvic exam and a vaginal ultrasound and said that it was not vaginal bleeding.
I asked the doctor if there was a possibility of pregnancy, and he said no, I was not pregnant.
However, I still experienced some bleeding the next day, although it was still minimal.
So, I went to the same clinic to see another doctor.
This doctor confirmed that it was indeed vaginal bleeding and performed a vaginal ultrasound.
He mentioned that even though I have been taking the birth control pills, I still ovulated.
I take my medication every night between 10:30 and 11:30 PM.
The doctor advised me to stop taking the remaining three pills and wait until the menstrual flow is heavier to consider it the second day of my period.

I would like to ask the doctor why I still ovulated despite taking the pills on time.
Has the psychological stress I put on myself this month affected this? Later, I visited another obstetrician who told me to finish the pills; otherwise, my cycle would be disrupted.
So, should I finish them or not? This doctor only performed an abdominal ultrasound and said there were no abnormalities, but mentioned that there could still be a possibility of a false ovulation.
I would like to know if pregnancy is possible in this situation.
My last menstrual period started on April 6, and the last sexual intercourse was on April 15, with condoms used every time and checks afterward.
I want to understand why I suddenly experienced bleeding, even though I have not bled since today.
Also, should I finish the remaining birth control pills? If the vaginal ultrasound did not show anything, does that mean I am not pregnant? Since I had ultrasounds for two consecutive days, will a pregnancy test show accurate results now?

Ting, 20~29 year old female. Ask Date: 2020/04/29

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, if you only experienced bleeding this time while taking the contraceptive pill, observe whether the same situation occurs next month.
If it does, it is recommended to switch to another type of contraceptive pill.
The contraceptive pill should not be stopped; otherwise, menstruation will occur.
To check for pregnancy, wait until your period is missed and then take a pregnancy test.
Wishing you good health.

Reply Date: 2020/04/29

More Info

It sounds like you are experiencing a complex situation regarding your menstrual cycle and the use of birth control pills, specifically the Diane pill. Let's break down your concerns and questions regarding unscheduled bleeding while on birth control, the possibility of pregnancy, and the implications of your symptoms.

Understanding Unscheduled Bleeding on Birth Control
1. Unscheduled Bleeding: It's not uncommon for individuals on hormonal birth control to experience unscheduled bleeding or spotting. This can occur for various reasons, including hormonal fluctuations, missed doses, or even stress. The Diane pill, which contains estrogen and progestin, can sometimes lead to breakthrough bleeding, especially during the first few months of use as your body adjusts to the hormones.

2. Pregnancy Risk: You mentioned that you have been diligent about taking your birth control pills and using condoms during intercourse. When used correctly, birth control pills are highly effective at preventing pregnancy. However, no contraceptive method is 100% effective. The fact that your doctor has performed examinations and indicated that you are not pregnant is reassuring. If there was no evidence of pregnancy on the ultrasound and you have been consistent with your pill regimen, the likelihood of pregnancy is low.

3. Possible Causes of Bleeding: The bleeding you experienced could be attributed to several factors:
- Hormonal Adjustment: As mentioned, your body may still be adjusting to the hormones in the Diane pill, leading to breakthrough bleeding.

- Stress: Psychological factors, including stress and anxiety, can affect your menstrual cycle and may contribute to irregular bleeding.

- Infection: You mentioned having a urinary tract infection (UTI). While UTIs typically do not cause menstrual irregularities, the stress and discomfort associated with an infection can impact your overall well-being and potentially your cycle.

4. Advice on Medication: Regarding whether to continue taking the remaining pills, it is generally advisable to finish the pack unless instructed otherwise by your healthcare provider. Stopping the pills prematurely can lead to further irregularities in your cycle. If your doctor has recommended stopping the pills due to the bleeding, it may be worth discussing the situation further with them to clarify their reasoning.

5. Follow-Up Testing: If you are still concerned about the possibility of pregnancy, you can take a home pregnancy test. These tests are most accurate when taken after a missed period. Since you have had unscheduled bleeding, it may be best to wait a few days after your expected period to take the test for the most reliable result.

Conclusion
In summary, unscheduled bleeding while on birth control can be a common occurrence and may not necessarily indicate pregnancy, especially if you have been consistent with your medication and have used additional protection. It is essential to communicate openly with your healthcare provider about your symptoms and concerns. If the bleeding persists or if you experience any other concerning symptoms, seeking further evaluation is warranted.

Remember, your mental and emotional well-being is just as important as your physical health. If stress is a significant factor for you, consider discussing coping strategies with your healthcare provider or a mental health professional.

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