Breakthrough Bleeding and Menstrual Changes on Birth Control Pills

Q: Breakthrough Bleeding and Menstrual Changes on Birth Control Pills

Hello： 1. <br>It is possible that the bleeding is just breakthrough bleeding from the hormonal medication, but you should still come in for an examination to rule out any gynecological conditions that could be causing abnormal bleeding. <br>2. <br>After stopping hormonal medicati

Long-term contraceptive pills

Hello, I started taking the long-term contraceptive pill (Wyeth ALESSE 28) for the first time last month.
My last menstrual period began on January 25, and I took my first pill on January 29.
On February 9, I started experiencing some bleeding, but it was not heavy.
By February 18, I had finished taking the 21 pills, and I continued to have daily bleeding from the day it started until I finished the 21 pills, although it was not as heavy as a regular menstrual flow.
There were no discomforts before the bleeding began.
I have the following questions:
1.
Why has my bleeding continued for so long? Is it because this is my first time taking the pill?
2.
As of today (February 22), it has been four days since I stopped taking the pills (but I have been taking the other colored pills in the pack).
I have not yet experienced any signs of my period.
How many days after stopping the contraceptive pill should I expect my period to arrive?
3.
If my period does not come, should I continue taking the next pack?

sa, 20~29 year old female. Ask Date: 2006/02/22

Dr. Li Guanghan reply Obstetrics and Gynecology

Hello: 1.
It is possible that the bleeding is just breakthrough bleeding from the hormonal medication, but you should still come in for an examination to rule out any gynecological conditions that could be causing abnormal bleeding.
2.
After stopping hormonal medication, withdrawal bleeding typically occurs within seven days.
3.
If your period does not arrive, you should come in for a pregnancy test.
Hsinchu City Hospital, Department of Obstetrics and Gynecology.

Reply Date: 2006/02/22

More Info

Understanding breakthrough bleeding and menstrual changes while on birth control pills can be quite concerning, especially for those who are new to hormonal contraceptives. Let's address your questions one by one, while also providing some context about the mechanisms behind these phenomena.

1. Why is my bleeding continuous? Is it because it's my first time using the pill?
Breakthrough bleeding is a common occurrence, especially during the first few months of starting a new birth control pill. This happens because your body is adjusting to the hormones in the pill. Alesse, like many combination oral contraceptives, contains estrogen and progestin, which work to prevent ovulation and regulate your menstrual cycle. However, during the initial adjustment period, your body may not respond immediately to these hormones, leading to irregular bleeding or spotting. This is particularly common in the first three months of use. If the bleeding persists beyond this period or becomes heavy, it’s advisable to consult your healthcare provider to rule out other potential issues.

2. When should I expect my period after stopping the pill?
After completing a pack of birth control pills, many women experience a withdrawal bleed, which is similar to a menstrual period. This typically occurs within a few days after finishing the active pills (the first 21 pills in a 28-day pack). However, the timing can vary from person to person. Some may experience their withdrawal bleed within a few days, while others might take longer. If you have been taking the placebo pills (the non-hormonal pills in the pack) and have not experienced a withdrawal bleed by the end of that week, it’s not uncommon, especially if you are new to the pill.
3. What if my period doesn’t come? Should I start the next pack?
If your period does not arrive after the placebo week, it’s important to consider a few factors. First, if you have been taking your pills consistently and correctly, the chances of pregnancy are low, but not impossible. If you suspect you might be pregnant (for example, if you missed any pills or had unprotected intercourse), it’s wise to take a pregnancy test before starting the next pack. If the test is negative and you still do not get your period, you can generally start the next pack as scheduled. However, if you continue to experience irregular bleeding or have concerns about your menstrual cycle, it’s best to consult with your healthcare provider for personalized advice.

In summary, breakthrough bleeding is a common side effect when starting birth control pills, and it often resolves within a few months. The timing of your withdrawal bleed can vary, and if you have concerns about missed periods or irregular bleeding, it’s always a good idea to reach out to your healthcare provider for guidance. They can help ensure that your contraceptive method is working effectively and address any underlying issues that may arise.

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