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two periods, then no period
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jessy_sue posted:
I've been on my birth control pill since March. Since about May or June I've been have a period on week 3 and again on week 4. I had protected sex in June. Then I didn't have a period in November. I don't now what's going on.
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Jane Harrison Hohner, RN, RNP responded:
Dear jessy_sue: Once pregnancy is ruled out as a distant possible cause of the missed period (unlikely if your last intercourse was in June with a condom), then my best GUESS Is that the culprit is "poor cycle control". Birth control pills were designed to offer very predictable bleeding patterns. But 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). In the case of a woman who does not have her "Pill period" the lining can get so thinned out that there is not much to shed. Sometimes the lining is unstable because the hormones can make parts of the lining out of synch. This is the most common cause of erratic bleeding during the weeks of active pills.

Bottom line, BTB (and missed periods) 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 you can find one that will give you super-predictable flows.

Yours,
Jane


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