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An_248056 posted:
I started taking birth control last month. After a few weeks I started spotting. It got to the point where it was like a period and it lasted for about 5 days. Now I am taking the "reminder" section with no hormones. I started taking the "reminder" pills about three days ago. My period has not come. Should I be worried? Is this normal?
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Jane Harrison Hohner, RN, RNP responded:
Dear An: 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 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. This is the most common explanation for erratic bleeding in the initial three months of Pill use--like what you have experienced. It can also be common if one has had bleeding all month for all the lining to be shed so there is no flow on the reminder/placbo pills.

Bottom line,once pregnancy has been ruled out, missed periods and BTB on hormonal methods of birth control is a nuisance side effect. The protection from pregnancy is still in 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. Hopefully things will straighten out by pack number three of your current birth control pills.

Yours,
Jane


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