Breakthrough Bleeding with Oral Contraceptives

Issues with Oral Contraceptive Use

Currently, I am using the Diane 21-day contraceptive pill for birth control, but I forgot to continue taking it after the 6th day.
Now, after stopping for 4 days, I notice some bleeding.
Does this bleeding count as my period? If I want to continue taking the pill, should I consider today as the first day of my period and continue taking the new 21-day cycle until the third day of bleeding? Thank you for your response.

YI, 30~39 year old female. Ask Date: 2022/07/06

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, if you miss taking the birth control pill for three days or more, the contraceptive effectiveness for that month is compromised.
You should stop taking the remaining pills and wait a few days for your period to start.
You can begin a new pack of birth control pills on the first day (or the fifth day) of your menstrual cycle.
If you miss pills and do not experience the expected withdrawal bleeding during the placebo period, you should consider the possibility of pregnancy.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2022/07/06

More Info

Breakthrough bleeding while using oral contraceptives, such as the Diane 21-day pill, can be a common occurrence, especially if there has been a missed dose. Breakthrough bleeding refers to unexpected bleeding that occurs between menstrual periods, and it can happen for various reasons, including hormonal fluctuations, missed pills, or even stress.
In your case, since you mentioned that you forgot to take the pill for a few days and then experienced bleeding, this bleeding is likely not your regular menstrual period but rather breakthrough bleeding due to the missed doses. When you miss a pill, especially during the first week of a new pack, it can disrupt the hormonal balance that the contraceptive pill maintains, leading to unexpected bleeding.

Regarding your question about how to proceed with your pill regimen: If you have missed pills, the general recommendation is to take the last missed pill as soon as you remember, even if it means taking two pills in one day. After that, continue taking the remaining pills as scheduled. If you have missed more than one pill, you may need to follow specific guidelines based on how many you missed and when you missed them.
If you experience breakthrough bleeding, it is advisable to continue taking your pills as scheduled. You do not need to treat the breakthrough bleeding as the start of a new menstrual cycle. Instead, you should continue with your current pack of pills. If the bleeding persists or if you have concerns about the amount or duration of the bleeding, it is wise to consult with your healthcare provider. They can provide personalized advice and determine if any adjustments to your contraceptive method are necessary.

In summary, the bleeding you are experiencing is likely breakthrough bleeding due to missed doses of your oral contraceptive. Continue taking your pills as directed, and if you have any further concerns or if the bleeding does not resolve, reach out to your healthcare provider for guidance. It's essential to maintain consistent use of your contraceptive to ensure its effectiveness and to minimize the risk of unintended pregnancy.

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