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Spotting while on the pill
An_247922 posted:
I have been taking the same pill for three years and never had a problem. Last Thursday I start spotting and still am with cramps. I am not suppose to start until next week. I have IBS and six years ago I had endoremso. (i know i did not spell it right) but could it have come back and started this.
Jane Harrison Hohner, RN, RNP responded:
Dear An: If you were diagnosed with endometriosis ("endo") six years ago, it would be a less likely culprit for for your current spotting and pain--because of the birth control pill use. Classically the hormones in the Pill will cause endo to regress. Thus pain and endo spotting tend to improve. Once off the Pill endo might be the cause of pain and spotting.

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. In your case it sounds like you are careful to take pills at the same time daily. More remotely, BTB and pelvic pain 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). This is the more common reason in a longer term Pill user. Sometimes the lining is unstable because the hormones can make parts of the lining out of synch.

BTB on hormonal methods of birth control is a nuisance side effect. 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. Also if the cramping continues other causes should be investigated (eg IBS flare, diverticulosis, etc.)


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