What actually is a withdrawal bleed?

[Berry124]

Hi, I have read the Oral Contraceptive Pill article but I still don't understand stuff about the pill with withdrawal bleeds. I started using Gederel, a combined pill to help reduce heaviness of my periods as well as ache. On the ache side, everything is fine and the only side effect I seemed to have gotten was breast tenderness for two weeks when using the pill(has gone now though) and increased hunger. I am happy with the pill so far as for the time after using the pill, my skin wasn't bad at all and only started getting a bit worse a week before my withdrawal period which was last week. Now I am having my withdrawal period which started the fourth day in my seven day gap and is still going. What I don't understand is if the pill stops you from ovulating, then why do you bleed? I know why someone not any birth control would bleed but I don't understand if the pill stops you from having a actual period or what, I really don't understand as I had PMS about five or six days leading up to when my bleed started but then all went for two days with the exception of cramping which started Saturday, day 2 of my pill free week and the cramps continued to when the then the bleeding started on the fourth day of the pill free week, and they are still there now. If you don't get a period when you are on the pill, then why do you bleed? I looked at my leaflet that came with the pills and there's nothing on there that explains this. I looked for hours online and couldn't find anything. If someones taking the pill and had unprotected sex and their pill fails without them knowing and it's early in the pregnancy so there's no symptoms, how would they realise that pregnancy has occurred like someone who isn't on hormonal birth control who would know when they didn't get their period? Also why do you get a withdrawal period when on the pill anyway? My leaflet said "take one pill every day for 21 days and stop for seven days. This is when you will get your withdrawal bleed" but why do you get a bleed? I read on here that some people when taking hormonal birth control may even not get any bleeding so I am guessing that it's not dangerous.

Another thing I don't understand is if the pill stops the lining from thickening, which is what the lumps/clots are when someone who isn't taking hormonal pills gets when they have their period, why can I see some of them? There's not as many as I used to have when I wasn't on the pill, but still a few and was wondering that if you don't actually get a period on the pill(my mum said this too) then why would you shed the lining as that's why you have a period and is what a period is.

I am really confused , I have looked on the site and I still don't understand this plus have looked at the leaflet so many times and on the pill companies website but I don't understand. Sorry if this is alot to read but I tried to understand it and I really don't.
Thank you.

[Heather]

Since this is how I explain how it works -- http://www.scarleteen.com/article/advic ... ebo_period -- if you have read that, can you let me know what it is you aren't getting there?

Menstrual flow doesn't clot like blood does (it also isn't blood, it just contains some). So, when people are seeing what they often mistake for clots, what that really is is either endometrial lining coming out more solid, menstrual flow combined with thick discharge, or both. And being on the pill doesn't change that.

Too, the withdrawal bleed IS still shedding of the lining. It's not a period in the sense that your own body is making it happen all by itself. It's called a withdrawal bleed because it mostly occurs when it does and how it does because your body is withdrawing from the synthetic hormones of your active pill (it creates a similar hormonal pattern as with periods, where both estrogen and progesterone levels get lower and lower until they are so low a period occurs) . The pill is designed to make that happen and work in concert with your cycle sans-pill so that you have that flow.

[Berry124]

Ok I will do Thank you Heather Oh yeah sorry I didn't mean clots, I meant the lining.

Oh I wondered why I could see parts of the endometrial lining still, I always have.

"Too, the withdrawal bleed IS still shedding of the lining. It's not a period in the sense that your own body is making it happen all by itself. It's called a withdrawal bleed because it mostly occurs when it does and how it does because your body is withdrawing from the synthetic hormones of your active pill (it creates a similar hormonal pattern as with periods, where both estrogen and progesterone levels get lower and lower until they are so low a period occurs) . The pill is designed to make that happen and work in concert with your cycle sans-pill so that you have that flow" -I get it now it makes sense because the reason why a period happens is due to change in hormone levels etc so if the pill creates a similar hormone pattern as with periods, do different pills contain different levels of hormones then depending on how far in you are to your pack, as I started getting pms symptoms I normally get before a period when I was on my last four pills?

[Heather]

Different pills don't all have the same levels of hormones or at the same time, but what nearly all brands and dosages have in common is that drop in progestin (the synthetic form of progesterone) that happens with the pill AND with cycles for people not using hormonal methods. Make sense?

[Berry124]

I read the link, I think I understand it A LOT better now and Iooked at one of the links which is very clear-pbs link- and one bit I found interesting was this bit-"The birth control pill jumps into this relay system midstream, delivering two key sex hormones that trick the brain into thinking the body is already pregnant. Scientific advances in creating synthetic hormones were essential to the development of the birth control pill." My mum told me that this is what the pill does, so she was right. If this happens, then I am guessing when you stop taking the hormones the body then thinks 'oh no egg today' due to the drop and change in hormones and the withdrawal bleed starts as you withdrawal from the hormone. Because of what the link says, would that explain why some people get spotting, headaches, cramps, breast tenderness and increased or decreased appetite like you do before a non-synthetic-hormonally-influenced-period as I read pms and pregnancy symptoms are literally the same? Or am I a bit off ? I study biology and love it o I am really interested to know how it works and if my understanding is correct.

[Heather]

I love that PBS piece.

Really, when that drop starts, what your body thinks is "time to slough off the lining." It's not about no egg today, because with a cycle sans the pill, that's not why periods happen, either. They happen because there is lining to be sloughed off, and again, the place your hormonal levels are at says, "and that time is now."

And yep, it's that hormonal shift and where those levels are that are most of why those symptoms happen, when they do happen for people.

[Berry124]

With the pills bit, yeah it does so the pills contain these drop in hormones and you get bleeding, then is there an exact reason as to why you still bleed, if you do, when on the 'placebo' or 'pill free' week? Is that the reason or is it so people would know if they needed to test for pregnancy if a risk happened?

Haha it's interesting I love science, especially Biology. Oh ok yeah that makes a bit more sense now

Oh ok yeah so when I started getting pms near the end of the pack, with four pills left, it was most likely due to that hormonal shift? My mum also loves Biology and is telling me all this stuff about the pill, she found out when I went to the doctor with her for Scarlet Fever and I think she's trying to scare me or something??

[Berry124]

She started confusing me saying all this about 'tricking the body' and 'not actually your period' etc and I just had 'information overload' crisis.

[Heather]

Again, you really don't "bleed." With or without the pill, menstrual or uterine flow has blood in it, but it has way more components than that, as we mention in our general information piece about periods.

You have that flow on the placebos because, again, your hormone levels are such to make it happen, and the pill is designed to create those levels, and because even though the pill thins that lining, it does still accumulate.

I can't know about your mother's motives in talking to you about this: you'd have to ask her!

[Berry124]

Oh yeah sorry yeah I know what the article said, it said secretions, the lining, dead cells and bacteria and a tad bit of blood.

Ok, I think I get it now yeah Ah ok, yeah because I remember being told that it doesn't fully over-ride your cycle.

I suppose not, mothers can be weird at times, I mean my mum likes my boyfriend and we were friends for sometime before we started going out so I do know him, but I swear she is trying to freaking me out, I mean the other day when I was talking about bone structure and mentioned that I ham 'fine' built or what ever you call it and said so was my boyfriend, she said " Well in that case your children will be pip-squeaks as your both fine built and average height" ?? I laugh at it now but tad weird haha. I'm not that small! I mean 5"5 1/2 isn't pip-squeek or 5"9 haha. She even started talking about me marrying my boyfriend??

[Heather]

Well, as a member if the pipsqueak tribe for reals, I would like to stand up for pipsqueaks everywhere and state more of us would not cause the end of the world.

Mind, genetics are also more complex than that, anyway. Both my parents are considerably larger and taller than I am, and yet

Maybe your mom is just trying to connect with you, however clumsily she may be going about it?

[Berry124]

Aw haha well im only average height. I used to be smaller than all my friends, then I hit 16 and shot up. Then stopped and shot back up before and during my 17th birthday, im taller than my mum aswell haha. Tallest girl in the family

Yeah they are very complex. Im built differently to all my siblings that proves the genetics bit in a way.
Maybe I have many misunderstandings with her as we are different in many ways but share similar brains, heck she gave me uneven hips that are painful when walking thx mum haha. My mum does seem to have trouble showing emotions and how she feels and clumsy describes both me and her in general haha.

Following the hormones side of pills, I remember my mum saying she got pregnant on the mini pill a year before having me and she said that it lea to an ectopic pregnancy that obviously had to he ended at 7week's, what is the effectiveness rate of the mini pill-progesterone only pill and if it's progesterone only then it must thicken cervical fluid and stop/prevent the endometrial lining from building up is that right?

[Berry124]

How could it have lead to an ectopic pregnancy? Does it even lead to that? What effect does progesterone have in terms of the fertilised egg and effecting whether it moves down the fallopian tubes for implantation?

[Mo]

You can read about the mini pill, its effectiveness, and how it works here: Progesterone-Only Oral Contraceptives (Minipills) I'm not aware of any connection between this form of birth control and ectopic pregnancies; this is a "correlation doesn't imply causation" sort of scenario. It's not always possible to know why ectopic pregnancies occur but there's no reason to assume it was related to your mom's form of birth control.

[Berry124]

Ok thankyou oh ok. With the withdrawel bleed, if someone was using the combined pill and was pregnant because the pills effectiveness was reduced, would they know when to test for pregnancy if the withdrawel period didnt happen? Or would the withdrawel bleed still happen? I know that the pill mimics the way your body would have a drop in hormones so low that the withdrawel period would happen, so when these synthetic hormones aren't taken into the body then if someone was pregnant, wouldnt the pregnancy hormone stop any loss of the endometrial lining because that's where the fertilised egg is? Plus when your pregnant other hormones rise to prepare your body for pregnancy, so there wouldn't be a drop in hormones, as they would be rising when you're pregnant and aren't taking any other synthetic hormones?

[Heather]

When people using hormonal contraceptives become pregnant, they usually miss their withdrawal bleed, just like people not using those methods will usually miss a period.

However, the vast majority of people using the pill properly will never encounter this, because they will not become pregnant in the first place.

[Berry124]

Oh ok so what I said about the hormones including the pregnancy one when the synthetic hormones aren't being put into the body was correct? Just making sure I understand it.that and it's interesting to learn about.

Being on the pill helped my anxiety go as there was something there to make.me.know that I had no need.to worry as something was there preventing things, and I read.it can be effective when taken during a period which I did. Is that true? I just had a panic about something and pregnancy even though I was told its not possible by you guys but had that anxiety because I was on antibiotics.

My appointment to arrange anxiety help with my doctor is in a week's time tomorrow, do you think there is anything I should do in preparation for it like anything that would be good to write down like doing certain sexual things?

[Berry124]

The fact that this isn't my 'actual' period just makes me.panic about pregnancy because I've been feeling I'll for the past few days and I know that you say symptoms aren't the best way to tell I've just been aching all.over and having bad headaches and trouble sleeping. I don't understand that there's only a risk from vaginal intercourse, anal and direct genital-to-genital contact and rubbing which would lead to fluid sharing, but not from manual even though it can lead to direct fluid sharing?? It's been a week since Ive been involved in manual or anything sexual that involves genitals (and not direct genital contact) because it just triggers me so I am trying to help myself.

[Heather]

You know we have a limit with you, however, on pregnancy panics, and we will not change that. We also need not to talk about risks you yourself do not in reality even have as if they were real. So, please respect this limit we keep setting, and I'd like for us not to have to remind you about it anymore, okay?

Again, this stuff is what you will need to bring to your intake for mental health services. I know you still have to wait another week and a half for that, but you just have to hang in there.

[Berry124]

I know I'm sorry I apologize. What I asked about the withdrawal bleed was just out of interest.

Ok, I am going to write a list of things when I have an arranged appointment and will have information ready.

Thankyou for the information and help.on understanding what a withdrawal bleed is and how and why it happens I am confident I understand it now.

[Berry124]

Hi, sorry to bother again, but I have question about the pill. I started on a Friday-December 2014 fourth day of my period, I used up a whole strip and took my last on a Thursday(Jan 1st 2015)and am currently on my withdrawal bleed. It's Friday tomorrow so I thought that I start my new pack of pills like I did last time on a friday, however the leaflet says start on the eighth day which would be Saturday, but that's not the same day as last time like it said on the leaflet?? The leaflet said you should start the same day each month, Saturday isn't the same day as last time? I am really confused do I start tomorrow or Saturday? Thx again.

[Keda]

You just miscounted.

Thursday - day 0
Friday - day 1
Saturday - day 2
Sunday - day 3
Monday - day 4
Tuesday - day 5
Wednesday - day 6
Thursday - day 7
Friday - day 8

[Berry124]

Did I? Oh silly me, so I do start tomorrow then? Ok thank you

I've been getting headaches since starting my pill free week and was wondering if it could be because of the pill. Should I contact my doctor because I heard you get an increased risk of strokes taking the pill. I looked it up and found a website that says migraines can occur during the pill free week, is this right?-"In some women with migraine who take the pill or have the patch, migraine attacks (episodes) may be triggered by the drop in the blood level of oestrogen during the pill-free or patch-free interval. So long as these migraine attacks are without aura, and you were known to have migraine without aura before starting the pill or the patch, there is usually no need to stop the pill or the patch. (If they are migraines with aura you should stop the pill or the patch.)" -http://www.patient.co.uk/health/migrain ... tive-patch . Should I contact my doctor about it?