Where is my withdrawal bleed?

[Juliaho90]

Hi there,

I know this isn’t a medical platform but I’m feeling too anxious so I thought I’ll post it here.

So I’m supposed to have my withdrawal bleed today, but until now it’s 4.30pm but still nothing. It usually comes in the afternoon, but I haven’t had any spotting at all and it’s freaking me out. I did have cramps and the pre menstrual signs but still no bleed. I had sex on 1 and 2 October and was 8 hours late for my pill on 6 October but have otherwise not missed any and took the rest of the pill on time. I haven’t taken a pregnancy test yet, but if I do take a test, will it be accurate? I’m not sure what to do at this point

To add I have been on my Yasmin pills for 2 years now so it isn’t a new pill issue.

Thanks!

[Juliaho90]

Ok just wanted to update that I totally forgot I had sex on 14 Oct too! And I couldn’t hear the suspense so I went to take a test and it is negative for now. Just feeling so anxious I’m not sure what to do. Is it too early to test considering I had sex on 14 Oct but expecting my withdrawal bleed today?

[Carly]

Hey Juliaho90 -- I would say it is a little early to test if you're concerned specifically about sex you had in October. At-home pregnancy tests are designed to detect high levels of human chorionic gonadotropin (hCG) in urine. hCG is a hormone that occurs naturally in bodies of people who can get pregnant at a low levels but spikes noticeably in early pregnancy. The hCG in your body needs to have risen enough to be detectable by the test, and if you've gotten pregnant in last 20 or so days might be too early. But! I also want to add that it sounds like you are pretty diligent birth control pill user. If you've been on birth control two years, using it correctly, and only recently took your pill ever so slightly late, you likely were not ovulating to begin with. As for your withdrawal bleed, it's possible to just miss it every once in a while. The pill thins out the lining of the uterus, aka endometrium, to prevent pregnancy. Sometimes your endometrium is so thinned out that there isn't much to shed for a withdrawal bleed.

For future reference, I'm asking you to review our Pregnancy Fear and Anxiety Policy and make sure you know what kinds of posts can get threads locked. Looking at your past posts it seems like you do have some anxiety about getting pregnant and using your birth control pills, and you've also asked about late withdrawal bleeds before. We know that wondering if you're pregnant is very stressful, so we created The Pregnancy Panic Companion to help sort through those feelings.

[Juliaho90]

Thank you! Does it mean that if my endometrium is thinned out so much, it is going to be the same next month? Like I won’t expect too much of a bleed? Is it ok or safe for the endometrium to be so thinned out? If I stop the pill, does it thicken back up?

So the update is that I experienced some bleeding late last evening and today it is still there. But the blood was little, like only taking up 1/4 of my pad but usually by the 2nd day it takes up 3/4. Now it is still sitting at like 1/4. I am kind of concerned that there isn’t even blood? I hope this is the withdrawal bleed?? I do feel the symptoms I get with my bleed so I am assuming it is… what do you think?

[Urna]

If you keep taking your pills regularly, your endometrium will thin out the same way every month, and you won't experience much of a bleed. It's safe for the endometrium to be thin, because all that that means is that you can't get pregnant, which is your goal here. A thin endometrium is usually a problem for those looking to get pregnant.

Here's the breakdown on why the endometrium gets thinned out after birth control pill use, from this site:-

In a normal menstrual cycle, hormones are produced by the brain which stimulate the ovaries to get an egg ready for ovulation and to produce estrogen. That estrogen production thickens the lining of the uterus, getting it ready for a pregnancy. After ovulation, the ovaries then produce progesterone, which stabilizes the uterine lining. When an ovulation does not result in a pregnancy, both hormone levels fall, which triggers the shedding of the uterine lining, causing a period.

Birth control pills contain estrogen and progesterone in every pill. Taken together, these hormones suppress brain stimulation of the ovaries so that you do not ovulate. In addition, estrogen and progesterone produce a stable and very thin uterine lining. In the placebo week of the birth control pills, there are no hormones in the pills and this lining will shed, resulting in a period. Some women taking birth control pills get such a thin uterine lining that there is nothing to shed, leading to skipped periods.

So what this means is that if you didn't take birth control pills one month, the endometrium (or the uterine lining) would thicken back up normally, because of your estrogen.

I hope this is the withdrawal bleed?? I do feel the symptoms I get with my bleed so I am assuming it is… what do you think?

Yes, it does sound like the withdrawal bleed.

Like Carly said in her last response to you, your posts are getting dangerously close to the kinds of posts that Scarleteen refuses to engage with, because they have to do with pregnancy scares and pregnancy anxiety. I assume you read the Pregnancy Panic Companion that Carly linked in that response, and our policy on pregnancy scare posts? If not, please go ahead and do that before asking us any other questions about birth control, withdrawal bleeds, or anxiety around birth control and taking pills on time.