Bleeding during active pills...?

[calamites]

I've been using a combination birth control pill since the beginning of 2012. At first my gyno told me it was okay to use them continuously so that I didn't have to deal with periods or withdrawal bleeding or whatever, but last year she insisted that I switch to a normal schedule with a week off after each pack of active pills so as not to risk my becoming infertile in the future. For the first few months everything seemed pretty normal, but since December my withdrawal bleeds have become totally irregular. Sometimes I barely bleed during the placebo week, others it's incredibly heavy and lasts for 14 days (or occasionally longer), and occasionally I end up with full-blown bleeding in the middle of a pack - as is the case right now.

My question is, what causes this kind of irregularity? Does it mean that the pills aren't working properly? And, of course, is there a way to make it stop?

[Heather]

If you used them continuously with NO breaks at all, that's one possible reason why things have been so weird.

But have you also been tested recently for STIs, and had a GYN, this one or anyone else, investigate this bleeding? If not, I'd suggest you do both.

Just FYI, what's okayed by the FDA for continuous use for people is taking four placebo breaks per year at a minimum. There is also no basis for concerns about fertility with continuous use, it's things like bone mass issues and increased cancer, blood clot and other risks that have merit and some kind of foundation in study or practice.

So, your GYN saying not only you had to stop because you'd risk infertility AND okaying nonstop continuous use without any placebo breaks for years leaves me concerned about the quality of this healthcare provider. So, if you can swap out to someone else to follow up with this -- the STI testing, the investigation into the unexplained bleeding for weeks at a time -- I'd suggest it.

However, this bleeding doesn't mean your pill is any less effective, or isn't working.