Combination Pill // Spotting Questions

[Fender909]

Hey!

I haven't written here in a while, but this website has helped me a lot in the past. I'm glad it is still around.

A lot has changed in my life since I've been active here. My life is pretty awesome and I'm fairly happy. I'd like to think I'm pretty educated on sexual health and safety. Anyway, I've found somebody that I'm happy and comfortable having sex with. I met them a little over half a year ago. I trust them greatly and I feel like I can communicate with them with ease. They have never pressured me to do something that I didn't want to do, as I've experienced with my previous (and first) sexual partner. This person talks to me throughout sex and asks me to let them know how I'm feeling, which I do.

The sex I've had isn't what this post is about, but I feel like laying all my new experiences out will help make my thoughts a little clearer. So, I first had manual sex with this person around two months ago. We've probably had around a dozen sexual encounters at this point, all of them being manual until a few weeks ago. We've had intervaginal sex two times now, one of those times being just three days ago. Both times we used a condom (+ water-based lube) that didn't break!

I've been on the combination pill for around a year now. The last pack I had to start a bit late because it was delayed in the mail. I missed one pill, and ended up taking two on the second day of the pack. Later, I missed a pill in the middle of the same pack (this caused a day of moderate bleeding). I had penatrative sex for the first time exactly three weeks after I missed the first pill of that pack, and about 12 days after the missed pill in the middle. I know that if you miss the first pill of the pack there's of the chance of the effectiveness being compromised, but I was wondering if three weeks of taking the pill would have made up for that possible loss of effectiveness.

My periods still sometimes vary in heaviness and in the times they start while I'm on the pill. The first time I had penetrative sex, I had started my period earlier that day. For the duration of the period, it was all very light and it had come earlier than usual (by 2-3 days). Since I've been on the pill, my periods tend to last around 5-6 days, this last one being 5 days long. When I started my new pack last Saturday, I started bleeding lightly again, with some brownish red clots and red discharge. I don't think I've ever experienced bleeding at the beginning of a pack before, and just wanted to know more about it. Also, are there reasons for periods coming a little earlier or being a little lighter than usual while on the pill?

Thank you so much, love you guys,

K

[Fender909]

PS: Is it possible that bleeding in the middle of the pack, as described, causes lighter bleeding during the placebo week?

[Karyn]

Hey Fender. Nice to see you back and glad to hear things are going well for you!

There's not really much to be said about bleeding during active pills, other than that sometimes it happens. Spotting or irregular bleeding can be a symptom of some STIs, so if you aren't up to date with your sexual healthcare then now is a good time to do that just to rule out any infection, but if you're all clear on that front then you can just figure it was your body doing something a little different to the norm. (As bodies tend to do from time to time.)

Per the differences you've noticed in withdrawal bleeds (the period you get while you're on the pill), that's also common and not something to be concerned about. The things that can affect cycles off the pill - illness, change in diet or exercise routine, etc. - can affect them while you're on the pill. So, again, it sounds like your body is just being a typical human body in that regard!

To answer your last question, yep, sometimes if you have some bleeding during the active pills of a pack, that can mean a lighter bleed during the placebo week. It doesn't always, but it can happen.

[Fender909]

Thanks for the reply.

Since I'm starting to become more sexually active I just want to make sure I'm as educated as possible and know what's what.

I've read that the first pill of a pack is crucial before, but what exactly does that mean? If you miss the first pill will it compromise the effectiveness of the whole pack or is it just like any other pill, where if you take the pills correctly for the 7 days following, you should be fully protected again?

Another question for future reference for my increasingly sexual self: How obvious is it when a condom breaks? What should I look for? Every time I've had penetrative sex I've made sure the condom's base was held upon withdrawal, and my partner has taken care of disposing of it.

[Karyn]

The first pill of the pack is especially important because if it's missed, essentially what happens is that the placebo week is extended beyond the seven days that it's designed to be, which increases the chances of ovulation happening. If you do miss the first pill, you want to use a backup method for at least 7 days.

When condoms break, it's obvious. Even a small hole will become larger very quickly, and a broken condom often looks like it's been torn or shredded: not something you can miss. If it looks intact, then you can trust it did its job.

[Fender909]

Thank you for all of your help, Karyn! Much love to you.

Do you have any extra advice for someone fairly new to sex? Precautions, tips?

[Heather]

In what respect? Are you asking about health issues, interpersonal issues, or...?

"Sex" is a big and diverse big thing, just like say, "eating" or "working," so beyond the kinds of articles we have already at the site that are fairly broad, advice around it that's useful usually needs to be pretty specific to a given person's own sexual life and sexuality.

[Fender909]

I guess I was just looking for things to keep in mind while exploring sex and sexuality as someone new to the world of it in general.

In the meantime, I thought of another question:

Is there an "adequate" amount of lubricant to use during penetrative sex? So as to assure the condom doesn't become too dry?

[Heather]

Generally, if you're putting a drop or two inside the condom for the wearer's comfort, and then as much on the outside (or on the vulva or anus, whichever body part we're talking about) as feels good, adding if at any point intercourse doesn't feel comfortable or feels "dry" you're all good. If at any point the condom got so dry that it might break, intercourse will generally feel pretty not-at-all good by that point, because intercourse with genitals that dry tends to hurt, rather than feel nice.

I can think of a few links here to start you with that I think of as good basics with what you're asking if you want some get-started places. Ince you start poking around in that content, you'll probably get a better idea of what you, specifically, feel like you need. Those are:
• Sexuality: WTF Is It, Anyway?
• What's Sex?
• Yes, No, Maybe So: A Sexual Inventory Stocklist
• Intimacy: The Whys, Hows, How-Nots, and So-Nots
• How to Understand, Identify and Make Choices About Desire
• Driver's Ed for the Sexual Superhighway: Navigating Consent
• Be a Blabbermouth! The Whats, Whys and Hows of Talking About Sex With a Partner
• Reciprocity, Reloaded
• Sorting Maybe from Can't-Be: Reality Checking Partnered Sex Wants & Ideals
• When Sex "Just Happened" (And How to Make It Happen Instead)

I'd also just drop a reminder that like most other big things in life, sex and our sexual lives are very much a learn-as-you-go situation, ideally where we learn both from education, but also from life experience, and reflection on both. So, not only can no one come into their sexual lives somehow knowing all there is to know -- both because there's so much to know, but also because our sexualities and sexual lives are individual, so a lot of that knowing is just about learning about ourselves, our partners and our relationships and interactions as we go -- that also would basically take away a big part value our sexualities and sexual lives can bring, which is the whole process and journey (the word journey always sounds so cheeseball, I know) of the thing.

[Fender909]

Thank you, Heather! That makes a lot of sense. I've been reading through some of the links you sent this morning.

I feel very grateful to have somebody who is so caring and willing to communicate with me.

[Heather]

Glad to do so!

[Fender909]

Another quick question about my pills -

I was away on a trip for around two days, but forgot to bring my pills with me. I missed one pill and was late on the other, and when I got back yesterday afternoon, I took two active pills together, after reading my pamphlet.

Since doing so, I've felt very achy and had some amounts of headaches and cramps. I've had spontaneous mood swings in which I feel like crying a bit. I didn't start bleeding after missing those pills, though. Could all these PMS-like things I'm experiencing be a result of the double dosage of pills? I've never had to do that before, so I'm wondering what my body is reacting to.

[Heather]

Chances are it's about both the missing of the pills and then double-dosing (which was the right thing to do, of course). The thing about methods like OCs is that it -- just like your own hormonal fertility cycle would do without them -- keeps those hormones at pretty consistent levels that only gradually change and shift, with the exception of the placebo week.

So, when someone misses pills or takes more of them at once than one, then those levels stop having those more gradual shifts. Some people, mind -- again, just like for some not using a hormonal method -- may barely notice a change or not experience any impact of that, while others are more sensitive.

OTOH, you might be having a headache because you have a headache, be moody because this week in the world has been an utter nightmare, and have cramps for some other reason entirely. It's pretty impossible to do more than make educated guesses with this stuff.

[Fender909]

Thanks!

Idk, I just feel like overall crap today. I felt ok in the morning, but as I started moving around I just started noticing all these sporadic aches and pains. My body is just generally hurting. Tonight I'm going to take ANOTHER two pills, so we'll see what happens.

[Heather]

Just keep an eye on it, eh? If this keeps up, probably worth a call into your general healthcare provider just to make sure something else isn't going on. On the other hand, as I write this to you I'm battling the flu, so who knows, maybe that's your story, as well. Yucky things do tend to go around in early spring.

[Fender909]

Good idea, Heather. There IS some nasty stuff going around here too.

[Heather]

How are you feeling today?

[Fender909]

Thanks for asking, Heather!

I took the other pair of pills last night and woke up this morning feeling nauseous and especially foggy. I'm thanking the two days of double dosage for that. As soon as I got on my bike to school, the nausea faded away.

My body is feeling tender here at school, and I'm a bit bloated in the lower abdomen. I felt a gush of bleeding at 10:30 in the middle of class, so I had to go put a tampon in! I was expecting some bleeding to happen from missing two days worth of pills, so I wasn't very alarmed. I feel ok right now. A tiny bit of cramping.

[Fender909]

I just wanted to write about my happiness with the communication I have with my partner. On Tuesday morning we were getting sexual with one another once again, and they went to go get a condom. I wasn't wanting to have intercourse that morning, so I just called their name to get their attention as they scrambled for a condom and all I had to do is tell them that that wasn't what I wanted to do that day. They just said "Ok." And then came back to me and we continued with the kind of sex we were having before.

I know this kind of understanding and respect and communication, without guilt, persuasion, or coercion is kind of a basic thing to ask for, but I feel so grateful to have a partner that will listen to me this way and care to hear what I have to say about the sex we're having. Maybe it's because the first person I was sexual with was the exact opposite. This person now doesn't "expect" anything from me, they really care for me. They've told me before that they would never make me do anything I didn't want to do and that makes me very happy.

Anyway, that was the first time I've really spoken up and made my voice heard in terms of sex, and I'm proud of myself! I was heard and respected and it was successful.

[Heather]

WAHOO FOR YOU! (And your partner, too!)