The Pill and Spotting?

[_itsmeisa]

I'm on a low hormone combined pill and I've been taking it properly since march. I'm now on the middle of my 3rd pack of pills since I've started, and last night I noticed a blood spot on my underwear. It's not a flow, but I can notice a brownish stuff if I stick my finger up my cervix. I am also having a little cramping. I guess it's spotting, right?

I know I can't be pregnant because I'm having my periods while on placebo pills when expected, and I'm also backing up with condoms everytime, no breakage.

My questions are:
Is it common to have spotting even after the 2 first packs of getting used to a brand of pills?
How about breast sensitivity? My breasts get swollen and ache everytime I start a new pack of pills!

Does it mean the pill is not being effective?

Thanks

[Ashleah]

Hi itsmeisa,

Sounds like what you are describing is spotting, but it is a good idea to get up to date on sti screening if you aren't already. It takes your body some time to adjust to the hormones, side effects may look different after a few months. Spotting and breast tenderness are both common side effects on the pill. Neither of these are signs that your pill is not doing it's job!

[_itsmeisa]

Are they symptoms of some STI? I also got checked in may and didn't have unprotected intercourse since then.

I forgot to mention that about 2/3 weeks ago, I had a week of diarrhea. Can the spotting be an effect of my body not absorbing the hormones properly during that time?

[Ashleah]

Just recommend staying update on sexual healthcare to rule out anything else, which you've been doing. Symptoms don't always present themselves when there is an STI but sometimes discharge can be sign of infection. But it sounds like what you are experiencing is spotting, common side effect from the pill.

While diarrhea can impact the effectiveness of the pill (which is why backing up with a condom is recommended), spotting is NOT an indication that your pill is not working.

[_itsmeisa]

I am not thinking I am bleeding because it's not being effective. I just thought that my body not absorbing the pill properly would mean a lower dosage of hormones on my body, and the drop of hormones would make me bleed like I were on the placebo pills. Does that make any sense?

Could you describe me what spotting looks like? How long does it last? Because I am still bleeding, it's been 2 days now. Maybe it's my period???

[Heather]

Spotting is a term used to describe light, sporadic vaginal or uterine bleeding. While what that looks like still varies a bit, the best comparison I can think to make is kind of like the bleeding a person can have a day or so after biting their lip, or having some of the skin of the lip get torn from them being dry, if that helps.

How long spotting lasts for someone isn't something that's a given. For instance, some people who have spotting as a side effect from hormonal methods of birth control, or an IUD, will have it happen almost daily, for months, while others will have it happen only a few times, for just a day or so, over years.

And do bear in mind that one of the most common side effects of the pill and other methods like it is for periods (or in this case, withdrawal bleeds), to become both lighter and shorter.

[_itsmeisa]

My periods are really shorter and lighter during the placebo week,but now the "spotting" has became a red flow with a lot of cramps, just like a period.

Is it possible to have your period mid pack? Will I get it again during the placebo week?

I hate not knowing what is going on with my body, I wanna feel like my pills are working the way they should.

[Karyn]

Yes, sometimes withdrawal bleeds do happen during the active pills, and it doesn't mean that your pill isn't working as it should. Especially in the first few months some irregularity is quite common, but that should settle down as your body adjusts. There's no way to predict, alas, whether you'll have another withdrawal bleed during the placebo week. Some people find if they have bleeding during the active pills, their withdrawal bleed is lighter, but that's not always the case and there's just no way to know what will happen with you.

Per feeling comfortable with the pill as a method, it's not uncommon for people to have a tough time trusting "invisible" methods like the pill or the patch, where the only way to know for sure they're working is that you don't get pregnant. If you haven't read it already, this piece might help a bit: Have a Little Faith in BC

Keep in mind too that just because you're on the pill doesn't mean you can't use another method too. Using condoms as a backup is always going to be best in terms of extra protection from pregnancy AND protection against STIs, and it can do a lot for your comfort level as well.

[_itsmeisa]

Thanks a lot

So, getting my withdrawal bleeding mid cycle doesn't mean I am ovulating and that the pill isn't working?
If I wanted to have sex without a backup method, would I have 99% or 92% protection, since I had heavy diarrhea?

[Sam W]

Like Karyn said, having a withdrawl bleed mid-cycle does not mean the pill is not working, it just means your body is still adjusting to being on the pill.
If you had diarrhea an hour or two after taking your pill that day, then it may have compromised the effectiveness. But, if you had it more than a 2-3 hours after, the pill had already been absorbed, so there would be no effect. But, if you're worried, backing up with condoms might be sound anyway.

[_itsmeisa]

Kinda had diarrhea all the time for a whole week, so... I am clearly poorly protected :/
If that's the case and I am still taking my pills, when will the protection reach it's maximum again?

[Heather]

Can you remind me if you and your partner are still backing up with condoms and doing so consistently?

[_itsmeisa]

Yeah, we use condoms every time and it hasn't broken up nor leaked. Even if we are just grinding.

I am thinking about not taking the placebo pills and starting the next pack right away so that would decrease my chances of having another withdrawal bleeding in a week or so (I wanna do it because my parents are traveling and me and my bf have an empty house to enjoy). What do you think?

[Heather]

Okay, so then there's no point in even talking about you having digestive issues, because it doesn't matter: condoms aren't impacted by that, and you use them as a backup. This is the point of a backup method: so you can know you're covered, even if and when your other method fails or wasn't taken properly.

Honestly, I think at this point, given the whole of your long post history that's almost entirely about fears of pregnancy or your contraception not working, it's time to be very strongly addressing the fact that you CLEARLY do not feel comfortable with some of this, and keep engaging in sex when you don't trust your contraception methods or feel confident in them.

So, I'd encourage you to really listen to all of these feelings -- feelings you have voiced here since last September, as a constant, and try to pay more attention to them. They're telling you you don't feel comfortable, and all the facts we have given you about your pill and condoms don't seem to have created any change with that.

That leaves you then, with two primary things to consider:

1) If you think using a different primary method that is more effective -- like an IUD , implant or depo-provera injection -- would make you feel more comfortable than you have felt up until now, or
2) If this is about simply not feeling okay about having sex that presents even the tiniest of pregnancy risks at this time in your life in situation, and so the problem is continuing to do something you just don't feel okay with, rather than taking this kind of sex off the table and sticking, until you do feel differently, to the kinds of sex, if any, you DO feel totally comfortable with, including after, not just during.

I would add that I think you engaging in sex without a backup method, like you asked about above, would not be a good choice for you. You already know, based on how you feel, you don't feel comfortable even when you ARE using two methods: taking one away is basically guaranteed to make you feel even less comfortable. Again, we really need to listen to our feelings with these things, rather than trying to ignore them or dismiss them. That's the only way we can figure out what we truly are okay with, and only do those things, so that we can have happy, healthy sexual lives we feel good about.

[_itsmeisa]

I feel 100% confident when I use the 2 methods (pill and condom) all together. I am not afraid I could be pregnant, I know I have been protecting myself just fine.
I just wanted to know more about my cycle and this mid cycle bleeding, since I don't want to risk having my withdrawal bleeding 2 times in the same month because it sucks. That's all.

[Heather]

Most of this thread is you voicing concerns about your pill now being effective (at preventing pregnancy, I'd presume, since that's what the pill does when it is effective), so I'm feeling pretty confused.

Since pills are in 28-day packs, and most months are 30 or 31 days, there are absolutely going to be times a person has a withdrawal bleed twice in one month. Too, as we have explained, some spotting (which isn't withdrawal bleeding) or breakthrough bleeding is simply a common side effect of hormonal methods like the pill.

If you want to take your pill packs back to back and your prescribing physician doesn't see any health reasons for you not to, by all means, that is a thing you can do if you like. However, just be aware that sometimes doing that results in LESS predictable bleeds and MORE spotting. How it does or doesn't work for you with that is something you can't know in advance.

[_itsmeisa]

Oh, ok, but I mean... I will be finishing this pack on the weekend, so I will have almost no break between the periods.
Just because I am asking about how my pills and cycle works doesn't mean I am anxious or panicking or something like that, I just want to know what to expect.
Thanks.

[Johanna]

This may well be your withdrawal bleed and it just showed early this month. Or you're having some breakthrough bleeding and will have your regular withdrawal next week. We can't really know, but breakthrough bleeding isn't unusual, as others have assured you, and since you're backing up with condoms anyway, you do not need to worry about compromised protection.

[_itsmeisa]

Only know I understood why I confused the staff. When I worry about bleeding, isn't about the effectiveness of the pill and not trusting it that I am concerned; it's just that me and my bf don't engage in anything sexual during this time because he faints when he sees blood. Sorry for not expressing myself properly!
I guess I am not starting the next pack right away anyways... my body is already having a hard time adjusting to the pill when taken properly, so it would be sound not to mess my cycle even more, right?

[_itsmeisa]

Also, can I stop bleeding if I take 2 pills at a time? I will be really unconfortable if I keep bleeding until the weekend.

[Sam W]

Hi itsmeisa,

Okay, that makes a little bit more sense. And no, taking two pills at a time would not get the bleeding to stop, and would also would not be sound because the pills are meant to be taken one at a time.

Have you and your boyfriend experimented with ways to be sexual/intimate during your withdrawl bleed that don't involve him seeing blood?

[_itsmeisa]

Oh, I read about this double pill method in a few websites that seemed reliable (.org sites for exemple)

And yeah, he gives me clitoral stimulation and oral when I am using a tampon, and I give him oral too. We planned having anal this weekend. Can I have anal with a tampon on? Or the motions can make it go up my cervix?

[_itsmeisa]

It's been 5 days and it doesn't seem like the flow is decreasing. Usually, my period ends on the 6th day. I still have minor cramps sometimes.
I have heard stories of women who bleed for 2, 3 weeks in a row. Is that possible?
I want to know how normal is this that I am experiencing and if I should go to the hospital if it lasts more than 7 days.

[Sam W]

No, there should not be any concerns about anal sex causing your tampon to get lost.

It could be that you're experiencing a slightly longer period than usual. However, if you find it starting to last more than about a week without any noticeable decrease and you're concerned, you may want to check in with a healthcare provider.

[Heather]

Just so you know this about your own anatomy, the cervical opening - the os - is waaaaaaay tinier than any tampon. No one has to worry about anything that isn't microscopically small - like bacteria, a virus or sperm cells - winding up inside the cervix. It's opening only gets wide like that when someone is about to give birth.