Second month with breakthrough bleeding. Help!

[Girltuesday2015]

This is my second month in a row with breakthrough bleeding before my placebo week. It's showing up as brown discharge.

I haven't missed any pills and only took one 3 hours late in the second week - it's a combined pill, and I know that's OK.

Does breakthrough bleeding mean the pill isn't as effective for me anymore? I really don't want to switch pills. If I can handle the breakthrough bleeding, can I stay on my pill? It's been 8 years.

Note - I did take Plan B 7 weeks ago, and had a horrible 4-day long anxiety attack that ended yesterday (unrelated to the Plan B). Could stress play into it?

[Redskies]

Breakthrough bleeding has nothing to do with the effectiveness of your pill, so there's no concern there.

It's possible it's connected to taking Plan B, because emergency contraception can cause some menstrual wonkiness for a few cycles. Changes in routine and the physical effects of stress and anxiety can also impact the menstrual cycle. Too, if this is happening shortly before your placebos, this may also just be a general variation for you, because bleeds aren't always exactly the same, and some people do start their bleed before they start the placebo pills.

Are you up-to-date with your sexual healthcare, including STI testing?

[Girltuesday2015]

Yep. All up to date (and so is my partner!)

Thanks, that's what I thought. I got nervous because I did a quick google and it returned with "your pill might not be strong enough." What's up with that? Is it because the estrogen dose or progestin dose may not be enough to stop breakthrough bleeding (but is still enough to prevent pregnancy)?

[Eddie C]

Bodies are not machines so they won't always work the same way. Also, bodies get affected by everything, like: food, sleeping, exercise, stress, etc. That's why is good to keep in mind that your birth control pill would not be the only explanation to every change you may have.

[Girltuesday2015]

I definitely understand that.

Could you provide any info on why sources say to switch pills after breakthrough bleeding and that the pill isn't "strong" enough?

[Sam W]

We can't really answer for why other sources say what they do. It is good to keep in mind that lots of online health resources that pop up are unmoderated forums, which don't tend to have reliable information.

[Girltuesday2015]

Makes sense - thanks!

Bottom line is that breakthrough bleeding does not mean it's less effective, right?

I wish that urban legend would go away!

[Heather]

No, it doesn't: that's just a common side effect. If anything, the fact that any medication is presenting known side effects of that medication tells you that medication is clearly in your system, or else you wouldn't be having effects from it!

However, if it's happening a lot and bothering you -- for obvious reasons, some people find a lot of unpredictable spotting an inconvenience -- some formulations of oral contraceptives are less associated with this side effect, so you can always ask your prescribing physician about making a switch to one of those, if you like.

You know, misconceptions about things like this do loom large, as do a lot of people whose work this isn't talking about contraception or other kinds of sexual health as if it is. By all means, just not being a person who talks out of their butt, as it were, is one thing anyone can do to help. But really, if no one is going places online to seek out this kind of information that aren't sound -- and NOWHERE crowdsourced ever will be, for the record -- or aren't looking to friends for information about their medications or methods rather than to healthcare providers, pharmacists, sexual health experts and other qualified people you're very unlikely to hear information that isn't factual, current and sound in the first place.

[Girltuesday2015]

It doesn't bother me for now, so I'll keep an eye out for next cycle.

Ugh, totally. Thank you again (and always) for your time. I've consulted this site so many times since I've been sexually active and I am so so so grateful.

[Heather]

Happy to be of help!