Scarleteen

Hi Scarleteen,

I've recently finished my 7 day break on my birth control pills, about a week and a half ago I started taking the pills again, after a bleed. However, about a week after being back on the pills and exactly a week after I last had sex I noticed some brown discharge which eventually turned into light, fresh blood. It was extremely light, only happening after I'd been to the toilet, and lasted about 24 hours. I'm rather concerned as I didn't miss any pills and this isn't normal for me. Lots of reliable websites seem to point me in the direction of a withdrawl bleed which scares me.

In my last pack, I actually ran 3 packs together, but finished a day early, through error. I didn't notice at the time so had the 7 day break as normal before starting a new pack. Would this have affected my contraception?

Thanks,

Samantha

Are you current with your sexual healthcare, including a full STI screening, particularly if you have recently been sexually active without engaging in safer sex (using barriers like condoms)?

Yes I'm completely up to date with that, that's actually the first time I've had sex since an all clear check. Making me even more confused

Okay.

So, one of the most common side effects of any hormonal contraceptive is breakthrough bleeding -- bleeding or spotting that can happen at any time, not just during withdrawal weeks. And with progestin-only methods, like the mini-pill, which is what you've been using (unless you switched since your last post), that side effect is all the more common.

If you aren't using the minipill anymore, and are taking combined oral contraceptives back to back without placebo breaks each pack, that also makes mid-cycle spotting or bleeding more likely.

So, if you know from testing this isn't about an infection, unless you haven't been taking your pills on time within that three hour window each day, what this most likely is is a common side effect of this medication.

If you remain concerned about this, or find it happening more frequently than you'd like, and not a side effect you want to live with, you can check in with your sexual healthcare provider, who can make sure this is a side effect, and, if so, and one you would prefer not to deal with, she can offer you some options to try for that.

Yeah, I'm not on the mini pill anymore, I'm on the combined pill. Thanks, you don't think it's anything to worry about then?

Also, one more little thing, is it ok/normal that I don't have my bleed until day 5/6 of my break?

Again, it sounds most likely to be the usual side effects of the pill, especially if you're taking packs back to back.

When people experience withdrawal bleeds starting is most often sometime within their placebo week: when during that week varies. And some people have their withdrawal bleeds start before or after that week, while some don't get them consistently in the first place.

Are there any other questions I can answer for you about using your pill?

Thanks Heather, you've really settled my mind

Two more little things, I understand the pill doesn't protect you from sti's however, in your opinion is it effective enough as the only method of contraception? Or would you reccommend backing up with condoms, which I usually do.

This also might sound silly but, does it matter that I take my pill without water?

So long as you are able to swallow your pills without water, it's all good.

Whether or not the pill is safe enough is about if it's safe enough for you. For some folks, that 91% typical use rate in a year totally feels safe enough. Others want higher protection from pregnancy than that, so either use a more effective single method, like an IUD, or back up with a second reliable method, like you are. We do know that use of two reliable methods, rather than one, is the hands-down best way to prevent pregnancy, so if that's what you're after, you've landed on it!

Thank you so much! You've really helped me

Sure thing!

Only just realised I said withdrawal bleeding not implantation bleeding in my very first question. Sorry about this being so late, but from what I described, is there any way that could be implantation bleeding?

It's not at all likely, given that being on the pill makes pregnancy unlikely and makes a bit of breakthrough bleeding pretty common. Too, "implantation bleeding" is rarer than a lot of less-reliable places on the internet make it sound. Bleeding is much, much more likely to signal "not pregnant".

It sounds like you're not feeling comfortable or confident about your pill preventing pregnancy. What do you think you need: for example, do you already have good information about how effective your pill is and how it works, or are there any gaps there we can help you fill? Or, would you feel better if you also used a second method, which would make the chance of pregnancy tiny?

Thanks for clarifying, I've just had this niggling feeling at the back of my mind.

I'm comfortable I know all the facts about the pill, I've learned a lot from the articles on here. I think my worrying has just proven to me that it's best for me to use a backup method too, to give me complete peace of mind, appreciate your feedback though, thanks so much

Do you need any help setting a limit about condom use with your partner? Often, when people are in this kind of spot where thought about backup methods is all about them, part of what's going on is that their partners aren't offering them up or doing their part to share this responsibility.

That's a good point actually. I'll speak to my partner and hopefully establish what I'm comfortable with. If I feel unsure about anything I'll be sure to let you know!