Prolonged Bleeding After Birth Control: What You Need to Know

Q: Prolonged Bleeding After Birth Control: What You Need to Know

Regarding your concerns, the response is as follows： Your questions should be addressed through a detailed diagnosis by a physician, and we hope you seek medical attention as soon as possible. <br>Thank you for your inquiry, and we wish you health and happiness.

Continuous bleeding for three weeks or more?

Hello, I underwent traditional surgery for endometriosis in 2011.
Over the past few years, my symptoms have worsened.
After examinations, I started taking oral contraceptives (levonorgestrel 150 mcg, ethinyl estradiol 30 mcg) at the end of 2019 to alleviate my symptoms.
In October 2020, I decided to skip my periods by continuously taking only the yellow pills.
During my first attempt, I experienced light bleeding that lasted for over two weeks, which stopped only after I discontinued the medication.
I consulted my doctor, who advised me to continue taking the pills.
However, this time I have been bleeding for almost a month, with the amount increasing from light to heavier.
Last week, I needed to take pain medication once a day, and this week I have to change sanitary pads three times a day, in addition to waking up at night due to pain.
Should I consider stopping the medication for a while and then resume taking it normally to allow my menstrual cycle to occur naturally? Thank you.

Xiao En, 30~39 year old female. Ask Date: 2021/01/10

Dr. Chen Zhiyu reply Obstetrics and Gynecology

Regarding your concerns, the response is as follows: Your questions should be addressed through a detailed diagnosis by a physician, and we hope you seek medical attention as soon as possible.
Thank you for your inquiry, and we wish you health and happiness.

Reply Date: 2021/01/10

More Info

Prolonged bleeding after starting or continuing hormonal birth control can be concerning, especially for someone with a history of endometriosis. It’s important to understand the underlying mechanisms and potential solutions to this issue.

First, it’s essential to recognize that hormonal contraceptives, like the combination pill you are taking (levonorgestrel and ethinyl estradiol), can affect menstrual bleeding patterns. Some women experience irregular bleeding or spotting, especially during the initial months of use or when they skip the placebo pills to avoid a period. However, prolonged bleeding lasting several weeks, especially with increasing volume, is not typical and warrants further evaluation.

In your case, since you have a history of endometriosis, it’s possible that the hormonal treatment is not adequately managing your symptoms. Endometriosis can cause heavy menstrual bleeding and pain, and while hormonal contraceptives are often prescribed to help alleviate these symptoms, they do not work for everyone. The fact that you are experiencing increased bleeding and pain suggests that your body may not be responding well to the current regimen.

Here are some considerations and recommendations:
1. Consult Your Healthcare Provider: It’s crucial to communicate your symptoms to your healthcare provider. They may want to perform a physical examination, ultrasound, or other diagnostic tests to rule out any complications such as fibroids, polyps, or other issues that could be contributing to your prolonged bleeding.

2. Evaluate the Birth Control Method: If the current hormonal contraceptive is causing adverse effects, your doctor may suggest switching to a different formulation or method. There are various options available, including different types of pills, hormonal IUDs, or other hormonal therapies that may be more effective for managing endometriosis symptoms.

3. Consider a Break: If your doctor agrees, taking a break from the hormonal contraceptive may allow your body to reset and could help in determining if the medication is the cause of your prolonged bleeding. However, this should be done under medical supervision to ensure that it is safe and appropriate for your situation.

4. Pain Management: Since you are experiencing significant pain, it may be beneficial to discuss pain management strategies with your healthcare provider. This could include over-the-counter pain relievers, prescription medications, or alternative therapies such as physical therapy or acupuncture.

5. Monitor Symptoms: Keep a detailed record of your bleeding patterns, pain levels, and any other symptoms. This information can be invaluable for your healthcare provider in determining the best course of action.

6. Lifestyle and Support: Consider lifestyle changes that may help manage endometriosis symptoms, such as diet, exercise, and stress management techniques. Additionally, support groups or counseling can provide emotional support as you navigate these challenges.

In summary, while hormonal contraceptives can be effective for many women, they may not be suitable for everyone, especially those with underlying conditions like endometriosis. Prolonged bleeding and pain are significant symptoms that should be addressed with your healthcare provider to find a suitable solution tailored to your needs. Always prioritize open communication with your doctor to ensure the best care possible.

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