Birth control pills are one of the most widely used methods of contraception among women. However, some women may experience spotting or bleeding when having these pills. This phenomenon is referred to as breakthrough bleeding by doctors.
Can Birth Control Cause Bleeding or Spotting?
Any kind of unscheduled bleeding that may occur when taking oral contraceptive pills is known as breakthrough bleeding. The bleeding may also be seen as a change in the method of contraception or taking medicine with different dosages of estrogen. The body may take time to adjust to the level of the new hormone in the body. This kind of spotting or bleeding usually stops on its own and stops within a few months of taking the pills. Most doctors do not view this phenomenon as anything serious because this is one of the most common side effects of contraceptive pills.
The light spotting or bleeding may not be a cause of serious concern but heavy or continuous bleeding may be a cause of concern as it may be indicative of some underlying medical complication. There are no solid reasons that explain why this kind of bleeding occurs by taking pills. One valid explanation or reason can be the increased amount of progestin in the body which changes the endometrium or the lining of the uterus. These changes lead to the thinning of the uterine wall which may cause spotting or bleeding.
It is important to keep a tab on normal bleeding while on contraceptives and also any spotting or bleeding that may occur for how long it occurs and when it occurs, as all these can help the doctor in establishing if there is any cause of concern.
Causes
Kind of contraceptive
There are some types of contraceptives that are more likely to cause breakthrough bleeding on the pill than other methods of contraception. Some of these contraceptives can include combination contraceptive pills and progestin-only pills. Combination pills are one of the most common and widely opted methods of contraception and it contains both kinds of synthetic hormones that are estrogen and progestin in it. Approximately 30 to 50% of women experience breakthrough bleeding in three to six months of taking these pills. Mini pills or progestin-only pills are another method of contraception that may lead to breakthrough bleeding and it may occur if miss taking the pill or don’t take it at the same time every day.
Missing the dose
Another common reason for spotting from birth control is when people don’t take the pills regularly or miss the dose. One must take pills regularly to avoid the discomfort and side effect of spotting or bleeding and also if taking a progestin-only pill or mini-pill one must take it every day at the same time.
The pill cycle
If one continuous contraceptive pill that keeps taking the pills for a few months such as the active pill or mini pill. If on such pills then more likely to experience breakthrough bleeding than other methods of contraception.
Taking other medicines
If taking other medicines along with the birth control pill such as epilepsy drugs, antiretroviral medicines, antibiotics etc. Then these medicines may interfere with the pills and lead to bleeding or spotting. Therefore, it is important to talk to the doctor before taking any such medicines that may tamper with the birth control pills.
Smoking – it may also interfere with the birth control pills and lead to breakthrough bleeding apart from increasing the risk of stroke and heart diseases.
Pregnancy – well, no method of contraception is full-proof in preventing pregnancy and the same holds true for contraceptive pills. Sometimes spotting and bleeding can also occur during the process of implantation.
Apart from the above reasons, sometimes vomiting or diarrhoea may hinder the body from absorbing the additional hormones in the birth control pills. This not only can make the pills ineffective but also lead to spotting or bleeding. Occasional diarrhea or vomiting may not do so but this may occur in women suffering from ibd (inflammatory bowel disorder), ibs (irritable bowel syndrome) and other such issues.
Birth Control Methdos That Cause Spotting
There are many methods of contraception that can be used for preventing pregnancy which includes intrauterine devices, barrier methods, hormonal methods, emergency contraceptives and natural contraceptives. In most cases, hormonal methods of birth control lead to spotting or bleeding. Here are some contraceptives that may lead to breakthrough bleeding –
- Bleeding or spotting can be seen on the birth control patch.
- It is common to experience breakthrough bleeding with iud (both hormonal and copper iuds) for a few months after implanting it.
- If using any continuous hormonal birth control pills, may experience breakthrough bleeding,
- Birth control pills with ethinyl estradiol and levonorgestrel may cause delays in the menstrual cycle. This may also cause lead to spotting.
- Depo-provera or depo shot can cause bleeding and spotting too.
- Hormonal birth control pills are taken for longer duration.
When Is Bleeding a Concern While on Birth Control?
It is common to experience breakthrough bleeding while taking birth control pills. However, if the birth control is not the reason for spotting or bleeding, then it may indicate some underlying health complications that mat require urgent medical intervention. Here are some reasons that may be a cause of concern –
- If had any kind of stis like chlamydia or gonorrhoea, then it may cause abnormal spotting or bleeding in between the menstrual cycle. Such kinds of infections can infect the cervix and lead to inflammation and bleeding. Apart from spot, also there is discomfort or pain during sex, cloudy urine, excessive menstrual bleeding or pelvic pain, if having any kind of sexually transmitted infections.
- Sometimes polyps or fibroids may also cause spotting or bleeding in between the periods. These benign growths may occur in women even after menopause. These abnormal growths can be removed by surgical intervention.
- Spotting or bleeding may also occur in some women when a fertilised egg implants itself to the uterine bleeding. The bleeding is usually noticed during the earlier stages of pregnancy. However, breakthrough bleeding in pregnancy may also be a sign of ectopic pregnancy or impending miscarriage. Therefore, as soon as any signs of bleeding occur during pregnancy, consult a doctor.
- Also, endometriosis breakthrough bleeding is a common phenomenon in women experiencing endometriosis. This is a condition where the endometrium or the uterine lining grows outside the uterus. Apart from bleeding and spotting, there are other painful symptoms that may be seen. There are some birth control pill options that can help in relieving the symptoms of endometriosis.
- Pid or pelvic inflammatory disease is a condition that affects the reproductive organs of a female body. This condition occurs when sexually transmitted bacteria enter through the vagina and affect other reproductive organs like uterus, ovaries, fallopian tubes etc. If sufferring from these conditions then may experience breakthrough bleeding part from other symptoms that may include fever, burning sensation while urinating, pain during sexual intercourse, pain in the lower part of the abdomen etc.
- Sometimes breakthrough bleeding may not be a serious cause of concern but still, it may be a good idea to meet the doctor and get diagnosed. Adolescent girls may experience breakthrough bleeding because it may take a few months to a few years for the body to get in sync with the changing hormones in the body. Again, the phenomenon is quite common during menopause and women often experience breakthrough bleeding in between the periods.
In most cases, constant bleeding on birth control for a few months after starting the pills is considered as one of the most common side effects of this contraception method. Most cases of breakthrough bleeding occur because the level of hormones in the pills may not be enough to prevent or control the occassional bouts of spotting or bleeding. This indicates that the body may require pills with a higher dose of estrogen that may reduce the chances of bleeding by thickening the uterine lining. Also, in the case of progestin only or mini pills, the bleeding may occur because the body may not respond well to the synthetic hormones. Well, no matter what the case is of breakthrough bleeding, it may be good idea to change the pill or method of contraception after talking to the doctor. Also, if breakthrough bleeding is accompanied with any kind of pain, is happening on regular basis, the bleeding is heavy or any such abnormal symptoms are noticed, it is important to get in tough with the doctor to rule out any underlying complications.
Prevention
- Take the pills regularly – this is because the body has to adjust to the new hormones that are introduced into it through these pills and that usually takes a few months.
- Take the pills at the same time – the efficacy of some pills is optimised only when taken at approximately the same time every day such as mini pills. Not doing so or a missed birth control pill may not only hamper with its efficacy but the body may also find it difficult to maintain the consistent hormonal balance which may cause breakthrough bleeding.
- Check if taking other medication – use of other medicines or taking prescription medicines on a regular basis may hinder the birth control pills and thus may cause breakthrough bleeding. If taking any prescribed medicines on a regular basis or otherwise and notice any spotting or bleeding, then must talk to the doctor about the same and look for other altenatives.
Conclusion
Some women may experience very light spotting that it may be difficult to establish whereas others may experience a considerable amount that may have to use a panty liner, pad or tampon. If experience any kind of spotting or bleeding for more than six months of using any method of birth control, talk to the doctor about changing the method of contraception. However, if any abnormal symptoms like pain, excessive bleeding etc may occur after using any birth control method, get medical help at the earliest.
References –
- https://pubmed.ncbi.nlm.nih.gov/12046776/
- https://www.healthline.com/health/birth-control/how-to-stop-spotting-on-the-pill
