Unexpected Bleeding While on Birth Control: What You Need to Know

Menstrual-like symptoms occurred despite not finishing the birth control pills?

Hello Doctor: I have been experiencing irregular menstrual cycles for a long time.
I visited the doctor on September 3rd and started taking medication to induce menstruation for 21 days.
My period started on October 3rd, and I began taking Diane contraceptive pills on October 5th.
During this period, I have experienced some bleeding, but it was only noticeable when wiping.
However, on the morning of October 24th, I noticed what seemed to be the first day of my period, with a brighter red color and a small amount of blood clots.
Is this considered a normal period or abnormal bleeding? Should I continue taking the remaining two contraceptive pills? Is there a need to switch to a different brand?

Niming, 30~39 year old female. Ask Date: 2021/10/24

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
"Abnormal vaginal bleeding" has many causes, including lifestyle habits and stress, age, vaginal infections, benign gynecological conditions, hormonal medications, and malignant tumors, among others.
Therefore, it is recommended that you visit a professional obstetrician-gynecologist for examination and evaluation.
2.
After inducing menstruation, it is common to experience menstrual cycle irregularities; it is advisable to monitor the situation for a while longer.

Reply Date: 2021/10/24

More Info

Unexpected bleeding while on birth control can be a concerning issue for many women, especially if they have a history of irregular menstrual cycles. In your case, it seems that you have recently started taking birth control pills (specifically, the Daili'an pill) after a period of taking medication to induce your menstrual cycle. This transition can sometimes lead to unexpected bleeding, which can be confusing.

Firstly, it’s important to understand that breakthrough bleeding or spotting is a common side effect when starting hormonal contraceptives, including birth control pills. This is particularly true in the first few months of use as your body adjusts to the hormones. The bleeding you experienced on October 24, which resembles the first day of your menstrual cycle and includes some red blood and small clots, could very well be breakthrough bleeding rather than a full menstrual period.
When you start a new birth control regimen, your body may take some time to adapt to the new hormone levels, which can result in irregular bleeding patterns. This is especially true if you have recently been on medications to regulate your menstrual cycle, as your body may still be adjusting to the hormonal changes.
Regarding your question about whether to continue taking the remaining pills, it is generally advisable to complete the current pack of birth control pills as prescribed, even if you experience unexpected bleeding. Stopping the pills prematurely can lead to further irregularities in your menstrual cycle and may increase the risk of unintended pregnancy.
As for whether you should switch brands, this decision should be made in consultation with your healthcare provider. If the breakthrough bleeding continues or becomes bothersome, it may be worth discussing with your doctor the possibility of trying a different formulation or brand of birth control. Some women respond better to different types of hormonal contraceptives, and your doctor can help you find one that minimizes side effects while effectively preventing pregnancy.

In summary, the bleeding you are experiencing may be a normal side effect of starting birth control pills, particularly after a period of hormonal treatment. It is advisable to continue taking the pills as directed and consult your healthcare provider if the bleeding persists or if you have any concerns about your menstrual cycle or the effectiveness of your birth control method. Regular follow-ups with your doctor can help ensure that you find the right contraceptive method for your needs and manage any side effects effectively.

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