Birth control effectiveness while spotting

[FadedPassion]

Hello,

I've been on birth control pills (Tri-cyclen) for 6 months. I take them at the same time everyday. Each month I occasionally get a little bit of spotting and cramping when it's not my break week. I rather not switch to a different pill because it took me so long to find one I like. Does spotting and cramping mean my birth control pills aren't 99.7% effective?

Note: I'm up to date on all STI tests

[Karyn]

No, spotting and cramping aren't an indication of the pill's effectiveness: they're just side effects that happen sometimes with hormonal methods, and it doesn't mean that anything is wrong. If you have been taking your pills as directed, then you can assume that you are fully protected.

[FadedPassion]

Thank you that makes me feel better. I'm just confused as to why it's happening. I know some people say I may need a higher dose to stabilize the lining, but if it wasn't strong enough to stabilize my lining then wouldn't it make it less effective? When I told my doctor that I'm also getting cramping on my one side by my ovary she suggested a cyst but I highly doubt that's what it is. I guess I was just worried because I thought a cyst was from when you ovulate. I just want to be reassured that I can stay on these pills and be protected 99.7%

[Karyn]

It's not always clear why some people have side effects on one type of pill but not another. These days, all pills contain pretty low doses of hormones, and the differences among brands are negligible, so while a higher dose may stop the spotting and cramping, it may not. Per the effectiveness rate, that 99.7% is from controlled drug trials, and very few people will have quite that level of protection over the course of a whole year, which is how effectiveness rates are calculated. If you are taking your pill at the same time every day, though, and nothing happens that would interfere with your pill, then you can assume that your protection is close to that.

As far as the cause of your cramping, it could be an ovarian cyst: people using hormonal birth control can get cysts, although they aren't as common in people using the pill or another hormonal method, and having one doesn't mean that your birth control isn't working.

[FadedPassion]

Yes I always take my pill at the same time everyday and nothing happens that would interact with it. The only thing I can think is that I've been very stressed in my personal life which I assume maybe causes the spotting.
As for the cramping, I've had it for a few months now, it's more like a dull ache where my left ovary would be. First my doctor thought a cyst and then the next time I saw her she didn't think so. It's not an extreme pain and I find it's a lot better when I lay down or I'm up and moving. It really only aches when I sit. I personally think it's because I work a full time desk job and I'm also in school so I sit a lot everyday.

[Sam W]

Did your doctor give an alternative explanation after she dismissed the idea of it being a cyst?

[FadedPassion]

Not really. She just said to keep an eye on it. She said it sounded muscle related. I have no idea, it's been going on for a long time but she didn't seem too concerned.

[Sam W]

It may be time to check in again, especially if it's not going away (and even if it is muscle related, it might help to get some advice on how to manage it). You may also want to get checked by an OB-GYN, as they're going to have more experience in examining and diagnosing things that may be related to your reproductive organs.

[FadedPassion]

Thanks. I really don't know. My doctor did a pelvic exam and poked around the area and it didn't hurt at all. I just saw a gynecologist last month and she didn't even do anything, didn't even want to examine me and said I was fine. I had an ultrasound done last summer for something unrelated but they checked my ovaries and said they were fine. I really don't know what more to do because no one seems to be concerned. I still think it's probably just from excessive sitting all day and lack of working out.

[FadedPassion]

My doctor also said it doesn't sound like a cyst because I usually feel it only when at work when I'm sitting down. Since it seems better when I walk around or on weekends when I'm not working then she thinks it's more muscle related. She also said with a cyst that the pain would usually be in the middle of my cycle and go away once I get my period.
I also just had a papsmear done on Thursday and for a couple days after that I kept getting a burning sensation in that same spot by the left ovary. It seems to have basically gone away now.

[Karyn]

If it's possible, I would get another opinion. Ongoing pain is something that should be taken seriously by a healthcare provider, not dismissed, so if the doctors you've seen haven't thoroughly investigated the cause of this pain then it's time to find another doctor.

[FadedPassion]

I'll see how it goes. None of them seem to be concerned so I'm sure it's nothing. It's not really pain, just more of an irritating ache.

[Karyn]

That works. If it does get more serious, though, it would be a good idea to check in with your doctor again.

[FadedPassion]

Oh yes of course. My doctor said to keep a log over the next 1-2 months and she also said to up my water intake and try to exercise a bit everyday to see if it helps. I used to go to the gym and do yoga a lot but stopped so I bet my body needs a stretch lol. I'm not too concerned since both medical professionals didn't seem to want to do further testing. I've already had a ton of blood work done and 2 ultrasound in the past 2 years and everything has always come back normal.

[Karyn]

Glad to hear it!