Women's Health Community

Dear An: It sounds like you are being plagued with breakthrough bleeding. Alas, breakthrough bleeding (BTB) can be a common side effect of most types of hormonal birth control (eg pills/patch/ring/shot/Mirena IUD). Among birth control pill users BTB frequently occurs after a missed or late pill. More remotely, BTB in a pill user can arise if she has gotten a chlamydia infection. Yet, if you both are monogamous this is not going to apply.

When a woman uses hormonal birth control it can make the lining of the uterus more unstable--so it is easier to have some of it begin to shed. Sometimes the lining is less stable because the hormones make the lining much thinner (actually this is good as a thin lining is a healthy lining). Sometimes the lining is unstable because the hormones can make parts of the lining out of synch. In the case of several missed/late pills parts of the lining are out of synch and begin to shed erratically.

If you continued on your pack as prescribed (after doing a catch up of the three pills) you may be troubled with the BTB for the rest of this pack--dang!. Stay on the regimen as ordered. If you have placebo/sugar pills take them as ordered even though you have been having consistent bleeding. Hopefully when you begin the next pack things will level back out.

If your poor cycle control persists you should return to your GYN or clinic. Often a change in the brand, or formula, of birth control pill will fix the problem. Lastly, if the missed pills were in the first week of this pack, and you had unprotected sex, you might want to get a pregnancy test at the beginning of the next pack--just for peace of mind.

Yours,
Jane