Experiencing unexpected spotting while on birth control is a common concern for many women. Breakthrough bleeding, as it’s often called, typically involves a small amount of light bleeding or spotting that occurs when you’re not expecting your period. While some may experience slightly heavier bleeding, it’s often just a noticeable change when using the restroom. Understandably, this can lead to worry, but in most cases, breakthrough bleeding is not a sign of a serious health issue and doesn’t indicate that your birth control is failing to prevent pregnancy. Fortunately, there are several approaches to manage and often resolve this issue.
Here’s what you should know about breakthrough bleeding and hormonal birth control.
Breakthrough Bleeding Can Occur with Any Hormonal Birth Control Method
Hormonal birth control methods work by releasing hormones that prevent ovulation and pregnancy. This can be achieved through various methods, including:
- Birth control pills: Daily oral contraceptives containing hormones.
- Birth control implant: A small, flexible rod inserted under the skin of the upper arm that releases hormones.
- Hormonal IUDs (Intrauterine Devices): Devices placed in the uterus that release hormones.
- Birth control shot: An injection administered by a healthcare provider, providing long-acting hormonal contraception.
- Vaginal ring: A flexible ring inserted into the vagina that releases hormones and can be placed and removed by the user.
- Skin patch: A patch applied to the skin that delivers hormones through absorption.
Certain Types of Birth Control Are More Associated with Spotting
While breakthrough bleeding can occur with any hormonal birth control, it is more frequently reported with certain types, particularly those that are lower in estrogen. Low-dose and ultra-low-dose birth control pills, the birth control implant, and hormonal IUDs are more commonly linked to breakthrough bleeding, especially when initiating use.
It’s particularly common to experience spotting and irregular bleeding in the initial months after hormonal IUD insertion. For most women with IUDs, this tends to improve significantly within 2 to 6 months. However, with the birth control implant, the bleeding patterns established in the first three months are often indicative of the bleeding pattern that will continue long-term.
Factors That Increase the Likelihood of Breakthrough Bleeding
Certain lifestyle factors and health conditions can make breakthrough bleeding more likely. For example, women who smoke cigarettes have a higher incidence of breakthrough bleeding. Inconsistent use of birth control pills, such as missing pills or not taking them at the same time each day, can also disrupt hormonal balance and lead to spotting.
Certain medications, including emergency contraception pills, are also known to cause irregular bleeding as a side effect. Additionally, some infections, such as sexually transmitted infections like chlamydia or gonorrhea, can increase the risk of irregular bleeding.
Furthermore, women who use birth control pills or the vaginal ring in a continuous regimen to skip their periods may be more prone to breakthrough bleeding. This is because the uterine lining may build up over time and shed irregularly. It’s also important to note that benign uterine growths, such as uterine fibroids, can cause abnormal bleeding that is independent of birth control use and should be evaluated by a healthcare provider.
Self-Care Strategies to Help Manage Spotting
For some women, making certain lifestyle adjustments can help reduce or resolve breakthrough bleeding. Quitting smoking is beneficial for overall health and may also help with bleeding irregularities. Ensuring that birth control pills are taken at the same time every day can also help maintain consistent hormone levels and reduce spotting.
If you are using continuous-dose birth control pills or the vaginal ring to avoid periods, consider scheduling a withdrawal bleed (period) every few months. This allows the uterus to shed its lining periodically, which can help minimize unscheduled spotting and bleeding.
When to Consult Your OB-GYN for Spotting
While breakthrough bleeding related to birth control is generally not dangerous, it can be bothersome and affect your quality of life. If you are experiencing persistent or bothersome spotting or irregular bleeding, it is important to consult with your OB-GYN. During a consultation, your doctor will discuss potential contributing factors and may perform a physical exam to assess the situation.
Once it’s confirmed that the bleeding is related to your birth control, there are typically several options to consider. For instance, your doctor might recommend switching from an ultra-low-dose pill to a low-dose pill, or adjusting the number of placebo or pill-free days in your cycle. Alternatively, exploring different birth control methods altogether might be suggested. For women using IUDs, implants, or the birth control shot, over-the-counter pain relievers like ibuprofen can sometimes help manage spotting, or your doctor may prescribe a short course of estrogen pills.
The key takeaway is that you don’t have to live with bothersome breakthrough bleeding. Consulting with your OB-GYN can provide personalized solutions and ensure that your birth control experience is comfortable and meets your needs.
