Spotting or Bleeding While on Birth Control – Why Does it Happen?

Birth control pills are one of the most widely used methods of contraception among women. However, some women may experience spotting or bleeding when they start taking these pills. This phenomenon is referred to as breakthrough bleeding by doctors. Here’s what you should know about this topic.

Can Birth Control Cause Bleeding or Spotting?

Any kind of unscheduled bleeding that may occur when you take oral contraceptive pills is termed as breakthrough bleeding. The bleeding may also be seen when you change your method of contraception or take medicine with different dosages of estrogen. Your body may take time to adjust to the level of the new hormone in the body. This kind of spotting or bleeding usually stops on its own within a few months of taking the pills. Most doctors do not view this phenomenon as anything serious because this is one of the most common side-effects of taking contraceptive pills. The light spotting or bleeding may not be a cause of serious concern but heavy or continuous bleeding may be a cause of concern as it may be indicative of some underlying medical complication. There are no solid reasons that explain why this kind of bleeding occurs by taking pills. One valid explanation or reason can be the increased amount of progestin in the body, which changes the endometrium or the lining of the uterus. These changes lead to the thinning of the uterine wall, which may cause spotting or bleeding.

It is important to keep a tab on normal bleeding while on contraceptives and also any spotting or bleeding that may occur, for how long it occurs and when it occurs, as all these can help your doctor in establishing if there is any cause of concern.

What Causes Spotting or Bleeding While on Birth Control?

Here are some of the common causes of bleeding while on birth control:

1. The Kind of Contraceptive

There are some types of contraceptives that are more likely to cause breakthrough bleeding on the pill than other methods of contraception. Some of these contraceptives can include Combination contraceptive pill and Progestin-Only pills. Combination pills are one of the most common and widely opted methods of contraception and it contains both kinds of synthetic hormones i.e. estrogen and progestin in it. Approximately 30 to 50 percent of women experience breakthrough bleeding in three to six months of taking these pills.

Mini pills or progestin-only pills are another method of contraception that may lead to breakthrough bleeding and it may occur if you miss taking your pill or don’t take it at the same time every day.

2. Missing the Dose

Another common reason for spotting from birth control is when you do not take your pills regularly or you miss your dose. One must take the pills regularly to avoid the discomfort and side-effect of spotting or bleeding and also if you are taking a progestin-only pill or mini-pill that you must ensure to take it every day at the same time.

3. The Pill Cycle

If you are on a continuous contraceptive pill that you have to keep taking the pills for a few months such as the active pill or mini pill. If you are on any such pills then you are more likely to experience breakthrough bleeding than other methods of contraception.

4. Taking Other Medicines

If you are taking other medicines along with your birth control pill such as epilepsy drugs, antiretroviral medicines, antibiotics, etc. then these medicines may interfere with your pills and lead to bleeding or spotting. Therefore, it is important to talk to your doctor before taking any such medicines that may tamper with your birth control pills.

5. Smoking

Smoking may also interfere with your birth control pills and lead to breakthrough bleeding apart from increasing your risk of stroke and heart diseases.

6. Pregnancy

Well, no method of contraception is full-proof in preventing pregnancy, and the same holds true for contraceptive pills. Sometimes spotting and bleeding can also occur during the process of implantation.

Apart from the above-mentioned reasons, sometimes vomiting or diarrhoea may hinder the body from absorbing the additional hormones in your birth control pills. This not only can make your pills ineffective but also lead to spotting or bleeding. Occasional diarrhoea or vomiting may not do so but this may occur in women who suffer from IBD (Inflammatory Bowel Disorder), IBS (Irritable Bowel Syndrome), and other such issues.

Birth Control Methods That May Cause Spotting

There are many methods of contraception that can be used for preventing pregnancy, which includes intrauterine devices, barrier methods, hormonal methods, emergency contraceptives, and natural contraceptives. In most cases, hormonal methods of birth control lead to spotting or bleeding. Here are some contraceptives that may lead to breakthrough bleeding:

• You can experience bleeding or spotting on the birth control patch.
• It is common to experience breakthrough bleeding with IUD (both hormonal and copper IUDs) for a few months after implanting it.
• If you are using any continuous hormonal birth control pills, you may experience breakthrough bleeding.
• Birth control pills with Ethinyl estradiol and levonorgestrel may cause delays in the menstrual cycle. This may also cause lead to spotting.
• Depo- Provera or depo shot can cause bleeding and spotting too.
• Hormonal birth control pills are taken for longer durations.

When You Should See Bleeding as a Concern

It is common to experience breakthrough bleeding while taking birth control pills. However, if the birth control is not the reason for spotting or bleeding, then it may indicate some underlying health complications that may require urgent medical intervention. Here are some reasons that may be a cause of concern:

• If you have any kind of STIs such as chlamydia or gonorrhoea, then it may cause abnormal spotting or bleeding in between your menstrual cycle. Such kinds of infections can infect the cervix and lead to inflammation and bleeding. Apart from spot, you may also experience discomfort or pain during sex, cloudy urine, excessive menstrual bleeding, or pelvic pain, if you are suffering from any kind of sexually transmitted infections.
• Sometimes polyps or fibroids may also cause spotting or bleeding in between your periods. These benign growths may occur in women even after menopause. These abnormal growths can be removed by surgical intervention.
• Spotting or bleeding may also occur in some women when a fertilised egg implants itself to the uterine lining. The bleeding is usually noticed during the earlier stages of pregnancy. However, breakthrough bleeding in pregnancy may also be a sign of ectopic pregnancy or impending miscarriage. Therefore, as soon as any signs of bleeding occur during pregnancy, you should see a doctor.
• Also, endometriosis breakthrough bleeding is a common phenomenon in women experiencing endometriosis. This is a condition where the endometrium or the uterine lining grows outside the uterus. Apart from bleeding and spotting, there are other painful symptoms that you may experience. There are some birth control pill options that can help in relieving the symptoms of endometriosis.
• PID or Pelvic inflammatory disease is a condition that affects the reproductive organs of a female body. This condition occurs when sexually transmitted bacteria enter through the vagina and affect other reproductive organs such as the uterus, ovaries, fallopian tubes, etc. If you suffer from this condition you may experience breakthrough bleeding apart from other symptoms that may include fever, burning sensation while urinating, pain during sexual intercourse, pain in the lower part of the abdomen, etc.
• Sometimes breakthrough bleeding may not be a serious cause of concern but still, it may be a good idea to meet the doctor and get yourself diagnosed.  Adolescent girls may experience breakthrough bleeding because it may take a few months to a few years for the body to get in sync with the changing hormones in the body. Again, the phenomenon is quite common during menopause and women often experience breakthrough bleeding in between their periods.

In most cases, constant bleeding on birth control for a few months after starting the pills is considered as one of the most common side-effects of this contraception method.  Most cases of breakthrough bleeding occur because the level of hormones in the pills may not be enough to prevent or control the occasional bouts of spotting or bleeding. This indicates that the body may require pills with a higher dose of estrogen that may reduce the chances of bleeding by thickening the uterine lining. Also, in the case of progestin-only or mini-pills, the bleeding may occur because the body may not respond well to the synthetic hormones. Well, no matter what the case is of breakthrough bleeding, it may be a good idea to change your pill or method of contraception after talking to your doctor. Also, if breakthrough bleeding is accompanied with any kind of pain, is happening on regular basis, the bleeding is heavy or any such abnormal symptoms are noticed, it is important to get in touch with your doctor to rule out any underlying complications.

Ways to Prevent Bleeding on Birth Control

Well, there are some measures that you can take, which may not only ensure optimum efficacy of your birth control method but they may also help in reducing or preventing the chances of spotting or bleeding:

1. Take your pills regularly

You need to take your birth control pills regularly. This is because the body has to adjust to the new hormones that are introduced into it through these pills and that usually takes a few months. You must keep taking your pills regularly even if you notice any kind of spotting. It may take up to six months for your body to adjust to the method of contraception.

2. Take your pills at the same time

The efficacy of some pills is optimised only when they are taken at approximately the same time every day such as mini pills. Not doing so or a missed birth control pill may not only hamper with its efficacy but the body may also find it difficult to maintain the consistent hormonal balance, which may cause breakthrough bleeding.

3. Check if you are taking other medication

Use of other medicines or taking prescription medicines on a regular basis may hinder your birth control pills and, thus, may cause breakthrough bleeding. If you are taking any prescribed medicines on a regular basis or otherwise and notice any spotting or bleeding, you must talk to your doctor about the same and look for other alternatives.

Some women may experience very light spotting that it may be difficult to establish, whereas, others may experience a considerable amount that they may have to use a panty liner, pad, or tampon. If you experience any kind of spotting or bleeding for more than six months of using any method of birth control, talk to your doctor about changing your method of contraception. However, if any abnormal symptoms such as pain, excessive bleeding, etc. may occur after using any birth control method, get medical help at the earliest!

Also Read:

Birth Control Methods for Male and Female
Chances of Pregnancy on Birth Control
How to Use Birth Control Patch