When taking the birth control pill, there are numerous benefits beyond preventing unwanted pregnancies. From managing heavy periods to easing menstrual cramps and PMS, the pill can also help prevent acne. However, some users may experience breakthrough bleeding, a common side effect that can be inconvenient and unpredictable. Here, Dr. Stephanie Hack, a board-certified OB/GYN and founder of Lady Parts Doctor, explains the reasons behind bleeding between periods while on hormonal birth control, how long it can last, and how to stop it.
Causes of Breakthrough Bleeding on the Pill
Several factors can contribute to irregular bleeding when taking the pill, including:
1. Forgetting to Take Your Pill
“Not taking your birth control pill at the same time every day can lead to hormone fluctuations, which might result in breakthrough bleeding.”—Stephanie Hack, MD, OB/GYN
2. Adjusting to a New Pill
Starting a new type of birth control may lead to spotting as your body adapts to the hormonal changes.
3. Unstable Endometrial Tissue
The pill can cause spotting by shedding unstable endometrial lining due to hormonal changes.
4. Pregnancy
Pregnancy can cause bleeding that might be mistaken for breakthrough bleeding, emphasizing the importance of taking pills correctly.
5. Other Medications
Certain medications like antibiotics or herbal supplements can reduce the effectiveness of birth control, potentially leading to breakthrough bleeding.
6. Underlying Medical Conditions
Health issues like STIs or uterine fibroids can also contribute to irregular bleeding between periods.
7. Vomiting or Diarrhea
Bouts of vomiting or diarrhea can interfere with pill absorption, reducing its effectiveness and possibly causing breakthrough bleeding.
8. Side Effects of Certain Pills
While breakthrough bleeding can occur with any birth control pill, it is more common with certain types like low-dose pills or hormonal IUDs.
Who is Most Vulnerable to Breakthrough Bleeding?
Individuals with specific risk factors are more likely to experience spotting between periods, including those who smoke, have certain infections, or use continuous hormone doses to skip periods altogether.
Duration of Breakthrough Bleeding
Initially, spotting when starting a hormonal birth control pill is normal and typically resolves within two to three months as the body adjusts to the new hormones. However, continuous hormone use may lead to irregular bleeding beyond the initial adjustment period.
Treatment for Breakthrough Bleeding
Although common, breakthrough bleeding can be bothersome. Dr. Hack recommends tracking patterns, quitting smoking, taking scheduled breaks from continuous hormones, adhering to a consistent pill schedule, using pain relievers when necessary, and consulting with your OB/GYN for personalized advice.
When to Consult a Doctor
While usually harmless, persistent or severe breakthrough bleeding may indicate underlying issues. It is advisable to seek medical advice if bleeding is accompanied by pain, occurs after intercourse, or persists beyond a few menstrual cycles or if other concerning symptoms arise.
Frequently Asked Questions
Can Stress Cause Breakthrough Bleeding on the Pill?
Stress can impact hormone levels and menstrual cycles, potentially leading to spotting between periods, although other factors are typically the main causes of breakthrough bleeding.
Can You Get Pregnant During Breakthrough Bleeding on the Pill?
Breakthrough bleeding may reduce pill effectiveness, increasing the risk of pregnancy. Consistent and correct contraceptive use is crucial to prevent unplanned pregnancies, especially during breakthrough bleeding episodes.