Breakthrough Bleeding After Missing Birth Control Pills

Q: Breakthrough Bleeding After Missing Birth Control Pills

Hello, <br>Your inquiry is addressed as follows： Each type of combined oral contraceptive pill comes in different formulations, and it is important to take the pills as directed. <br>If you forget to take a pill, you should take it as soon as you remember, and continue taking the

Regarding missed doses of emergency contraceptive pills?

Hello, doctor.
My girlfriend has been taking the contraceptive pill, Yaz, for three months, and she has been taking it regularly and on time.
Her menstrual cycle is regular, occurring every 28 days, lasting about 5 days.
October 1st was the first day of her fourth pack, but she forgot to bring her pills during the holiday on October 9th and has not taken them for more than 3 days.
On October 11th, she experienced some bleeding, and on the 12th, the amount was similar to the first day of her period.
Today, the 13th, the bleeding has decreased.
She usually tracks her menstrual cycle with an app, and her ovulation date was on October 11th, with her next expected period on October 25th.
Could you please advise whether the bleeding is due to breakthrough bleeding after stopping the pills or ovulation bleeding? Additionally, if she wants to continue with a new contraceptive pill, should she start taking it on the first day of her next period at the end of the month? Thank you.

Aaa, 20~29 year old female. Ask Date: 2015/10/13

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello,
Your inquiry is addressed as follows: Each type of combined oral contraceptive pill comes in different formulations, and it is important to take the pills as directed.
If you forget to take a pill, you should take it as soon as you remember, and continue taking the next pill at the usual time.
If more than 12 hours have passed since the missed dose of an active pill, in addition to taking the missed pill, it is advisable to use an additional barrier method of contraception for the next seven days.
If more than 24 hours have passed since the missed dose, you should stop taking the current pack of pills and refrain from taking them for seven days (including the days you missed), then continue with the next cycle.
If you miss a pill and do not experience expected withdrawal bleeding during the placebo period, you should consider the possibility of pregnancy.
It is recommended to start a new cycle of pills on days 10-15.
If you have had sexual intercourse during this time without any other contraceptive measures, it is essential to check for pregnancy first.

Thank you! Wishing you safety and health.

Dr.
Zhang

Reply Date: 2015/10/13

More Info

Breakthrough bleeding after missing birth control pills is a common concern among women using hormonal contraceptives. In your situation, it appears that your girlfriend has been taking the birth control pill consistently for three months, which typically helps regulate her menstrual cycle and prevent unintended pregnancies. However, missing pills can disrupt this regulation and lead to unexpected bleeding.

When a woman misses one or more birth control pills, especially during the first week of a new pack, it can lead to a drop in hormone levels. This drop may cause breakthrough bleeding, which is often lighter than a regular menstrual period. In your case, since your girlfriend missed pills for more than three days and then experienced bleeding, it is likely that this bleeding is a result of the missed pills rather than ovulation bleeding. Ovulation bleeding, if it occurs, is usually very light and occurs around the time of ovulation, which in your girlfriend's case was on October 11th. However, given the timing of her missed pills and subsequent bleeding, it is more plausible that this is breakthrough bleeding due to the hormonal fluctuation caused by missing the pills.

Regarding the continuation of her birth control regimen, it is generally recommended to resume taking the pills as soon as she remembers, even if it means taking two pills in one day. If she has missed more than two pills, she should follow the specific instructions provided with her birth control pill pack, as different brands may have slightly different guidelines. Typically, if she resumes taking the pills, she should continue to take them daily at the same time.
As for starting a new pack, the standard practice is to begin taking the new pack on the first day of her next menstrual period. This ensures that she is protected against pregnancy from the start of the new pack. If she experiences any irregular bleeding or has concerns about her menstrual cycle, it is advisable for her to consult with her healthcare provider for personalized advice and to ensure that her contraceptive method is still effective.

In summary, the bleeding your girlfriend is experiencing is likely breakthrough bleeding due to missed pills rather than ovulation bleeding. She should resume taking her birth control pills as soon as possible and consider starting a new pack on the first day of her next period. If she has any further questions or experiences significant changes in her menstrual cycle, she should reach out to her healthcare provider for further evaluation and guidance.

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