Scarleteen

I recently started the patch and applied my first one Monday, October 24th. I have been changing it on Mondays as instructed, and am currently on my third patch. I have had no side effects until today and yesterday, and am noticing some spotting and very light cramping. Prior to starting this, I had a somewhat irregular cycle, however, counting 28 days from my last period, I would have had a normal period this week if not on birth control.

From doing some research on the internet, I've learned that this is breakthrough bleeding, and that on the 4th (patch-free) week, what's supposed to happen is not a true period but withdrawal bleeding. As a birth control novice, however, I have several questions that other websites haven't been able to provide a clear and reliable answer to.

Is the breakthrough bleeding normal and what is it caused by? If I'm having this breakthrough bleeding, will I still have my "period" (withdrawal bleeding) next week? And if withdrawal bleeding is not a true period, can it still be taken as a sign of not being pregnant the way a true period can? (As in, can you be pregnant and still have withdrawal bleeding?)

Welcome to the boards!

Breakthrough bleeding and spotting is a common side-effect of hormonal contraception, including the patch. It can happen any time that someone's taking it, but it's especially common in the first few months of using a new method, because your body needs time to adjust to the slightly different hormonal patterns that you're now giving it. If you would've been having a period now if you weren't using the patch, and you're still on the third week, this spotting at the moment may be part of your withdrawal bleed, because it often takes a cycle or three for your body to get properly synced with your new method.

There's no way to predict whether you'll have a withdrawal bleed next week. Each body responds differently, and the only thing to do is wait and see what yours does, especially while your body is still settling in to the method. Overall, with time, you'll probably have a withdrawal bleed around the time of your patch-free week. Things to know if you don't already, so it's not a surprise: having lighter bleeds, or bleeds be a bit different in some other way, is common for people using hormonal contraception, as is skipping a bleed completely sometimes.

Someone who isn't using any hormonal contraception will have a period as part of their fertility cycle. After an egg is released, if it isn't fertilised or it doesn't attach to the uterus wall, a domino-effect of different hormones will send signals and trigger a period. For someone who is using hormonal contraception, it works a bit differently: we don't call it a period because it's not triggered by the fertility cycle. Instead, a bleed happens because your body is withdrawing from the hormones you were taking for the weeks previously. In a period and in a withdrawal bleed, the lining of the uterus is being shed. So yes, that shedding in both cases strongly indicates that someone isn't pregnant, because the lining would be needed to sustain a pregnancy. Too, if someone was pregnant, their body would be sending and receiving dramatically different hormonal messages, and those messages would not trigger a bleed - instead, the body would be keeping and building up uterine lining.

Does that clear things up for you? Anything else we can do for you today?