Oral contraceptives are a group of contraceptives whose action is based on suppressing ovulation through hormonal action. Despite their high effectiveness and popularity, they have a side effect in the form of minor bleeding.
The severity of the discharge depends on the specific drug and the individual characteristics of the female body. Read this article to learn how to avoid the unpleasant consequences of taking hormonal contraceptives.
Spotting during ovulation
Oral hormonal contraceptives have long proven their effectiveness and are widely used in gynecological practice, but their side effect is very often minor bleeding during ovulation, which usually disappears after the adaptation period. In almost half of women it stops after two to three months of continuous use, but for some it may last every cycle.
Doctors explain this phenomenon by changes in hormonal levels in different phases of the cycle. In the first days, an increased synthesis of estrogen occurs in a woman’s body, the concentration of which reaches its peak at the time of ovulation. After the egg leaves the follicle, the production of progesterone begins, which prepares the endometrium for the possible consolidation of the fertilized egg in the event of pregnancy.
It should be noted that when taking oral contraceptives, ovulation as such does not occur, since their action is aimed at suppressing this process.
All contraceptives contain a certain concentration of hormones, but it is slightly lower than the level of the natural amount of active substances produced by the female body. In order for the endocrine system to adapt to changes in hormonal levels, it takes some time, which is determined by the individual characteristics of each woman.
Expert opinion
Daria Shirochina (obstetrician-gynecologist)
If bleeding continues for more than six menstrual cycles and is accompanied by significant blood loss, the contraceptive method should be changed after consultation with a gynecologist.
Minor spotting between menstruation does not affect the contraceptive effect of the drug used, but its reliability directly depends on the regularity of taking the pills.
Causes of bleeding when taking birth control pills
Other causes of spotting between periods include:
- smoking, since nicotine has the ability to suppress estrogen activity;
- incorrect use of pills, skipping the next dose, sudden withdrawal, since in this case a sharp change in hormonal levels occurs in the body;
- treatment of diseases for which antibiotics and drugs are prescribed to normalize the functions of the central nervous system;
- vomiting of various etiologies, in which the contraceptive pill may not enter the stomach and be absorbed into the blood;
- the use of various herbal products, for example, containing St. John's wort;
- individual reaction to a contraceptive.
Types of discharge and their features
Depending on what phase of the cycle the spotting appears when taking oral contraceptives, the doctor can determine what the problem is and, if necessary, select a different drug.
At the beginning of the appointment
Sometimes minor bleeding appears in the first days after the end of menstruation, usually in the first month after starting to take contraceptives.
If the discharge does not stop after the end of the adaptation period, this may be a sign that the chosen contraceptive contains too little estrogen. In this case, you need to choose another drug after consulting your doctor.
At the end of the package
Continued bleeding at the end of the cycle indicates insufficient concentration of gestagen; this situation also requires a change in contraceptive.
If there is too much bleeding
Minor spotting should not cause concern to a woman; this side effect is mentioned in all instructions for taking oral contraceptives. But in some cases, bleeding between periods takes on a breakthrough character. If this is not associated with any pathologies, then this phenomenon is usually also associated with a period of adaptation of the body to changes in hormonal levels.
Heavy bleeding may be due to the increased effect of progestogens on the uterine endometrium; under their influence, it begins to atrophy ahead of schedule, provoking significant bleeding. The concentration of estrogen in oral contraceptives is very low, and they are not able to adequately perform a hemostatic function.
For more information on the causes of intermenstrual bleeding, watch this video:
Cancellation of hormonal contraception
Photo: Brown discharge when stopping OCs.
With long-term use, stopping the pills should be consistent, over several cycles. For this purpose, medications with lower hormone content are prescribed. This will help avoid serious side effects.
Usually, bleeding occurs a couple of days after stopping the drug. Its intensity and duration may vary. Most often it is a brown mass that is released over the course of two weeks.
This phenomenon is associated with changes in hormone levels. Its normalization will occur gradually over several months. Menstruation from scanty brown discharge will eventually become traditional - the same as before taking the pills.
However, it is recommended to perform a pregnancy test on the first day of pseudomenstruation to rule out the possibility of uterine bleeding during pregnancy.
If you have regular, prolonged discharge while you are discontinuing OCs, you will need to visit a specialist to rule out the possibility of a serious pathology.
When it is necessary to see a doctor
Consultation with a gynecologist may be necessary in the following cases:
- the contraceptive was selected by the woman independently without prior examination, which caused severe bleeding;
- spotting appears daily, regardless of the phase of the cycle;
- unpleasant phenomena continue for more than 2 - 3 menstrual cycles;
- bleeding is accompanied by other sensations: vaginal dryness, pain in the lower abdomen, discomfort during sexual intercourse.
Emergency medical care is required in cases where spotting while taking hormonal contraceptives is accompanied by the following alarming symptoms:
- pain in the chest and retrosternal region, accompanied by shortness of breath;
- sharp pain in the lower abdomen;
- swelling, leg cramps;
- severe headaches that occurred after starting to take contraceptives;
- vision problems, speech disorders and other neurological pathologies.
Medical attention is also required if various rashes appear on the skin, yellowing of the whites or skin on the face and body, or problems with emotional status.
We recommend reading about menstruation while taking birth control pills. From the article you will learn about the benefits and harms of taking contraceptives, the effect of contraception on the body, menstruation after various types of OCs.
And here is more information about medications for heavy menstruation.
Doubling the dosage
In cases where pregnancy is not confirmed, the specialist, as a rule, advises doubling the dosage of the drug taken (1 tablet in the morning and in the evening). In this mode of taking the contraceptive, it should be taken until the bleeding stops, and then return to the usual regimen of taking the drug: 1 tablet per day. Since the course of such medications should not exceed 24 days, most likely you will need to purchase another package of the medication.
It is very important to know that for monophasic hormonal contraceptives the composition of the tablets is absolutely identical, while for combined oral contraceptives the pills are numbered in the active cell corresponding to the day of use of the drug. However, it should be remembered that if breakthrough bleeding occurs while taking birth control, it is not recommended to stop using the drug, as this will only make it worse.
Important information for women before starting to take contraceptives
Although minor spotting between menstrual cycles when using oral contraceptives in most cases is not a pathology, it can cause some discomfort to a woman.
To avoid these unpleasant side effects, before starting to take them, you must undergo an examination for the presence of contraindications and consult with your doctor about choosing the optimal drug, taking into account individual characteristics. It is also important to strictly adhere to the dosage regimen and take the pills at the same time.
If for any reason a woman needs to stop using hormonal contraceptives, to avoid unpleasant consequences in the form of bleeding, the following recommendations must be followed:
- before the drug is completely discontinued, you need to stop taking all the pills from the monthly package, in this case, after the end of the dose, menstruation will begin, and in the next cycle the regularity of menstruation will normalize;
- before stopping the use of contraceptives, you should consult your doctor, since in many cases hormonal drugs are prescribed not for the purpose of preventing unwanted pregnancy, but for the treatment of certain diseases of the female reproductive system;
- undergo an examination and take tests for hormones to determine their balance in the body.
There are situations when, despite the existing side effects, oral contraceptives cannot be stopped. This happens in the following cases:
- the presence of neoplasms of a malignant nature;
- chronic liver diseases;
- persistent hypertension;
- diabetes.
Expert opinion
Daria Shirochina (obstetrician-gynecologist)
Abrupt withdrawal of oral contraceptives causes an increase in ovarian function, which is used in medical practice in the treatment of infertility.
Oral contraceptives, like any other medicine, cannot be used uncontrolled and without a doctor's prescription. Bloody discharge between periods is in most cases a normal physiological phenomenon, but if it intensifies and causes significant discomfort, consultation with a gynecologist is mandatory.
FAQ
Despite the fact that modern types of contraceptives have several varieties according to the method of application and effect, all of them are intended primarily to protect the female body from unplanned pregnancy.
Modern pharmaceuticals offer a wide range, among which birth control pills are one of the most popular forms of drugs aimed at ensuring safe sex in relation to pregnancy that is unexpected for both partners. A feature of some drugs is the presence of certain side effects, manifested in the form of hormonal imbalance, possible disruptions in the menstrual cycle and bleeding of various types. These and other problems create a lot of troubles and uncomfortable sensations, therefore, many women, before using this kind of contraceptives, try to find out by asking questions the degree of safety of this type of contraceptives in relation to the female body and reproductive system and their reliability in use.
Can I bleed from birth control medication?
Almost every woman experiences vaginal bleeding that is not menstrual flow. The reasons why such phenomena occur may differ in their nature, but one of them may be the use of contraceptives, which provoked a short-term hormonal imbalance.
Any bleeding from the vagina that is not associated with the menstrual cycle is a pathology of the intermenstrual period. An excessively long period and excessive bleeding after taking birth control pills is one of the signals that requires the intervention of medical professionals in order to clarify the situation and eliminate the causes of the manifestation.
What is the mechanism of action of oral contraceptives?
The main task of oral contraceptives is to inhibit the pituitary system, which simultaneously suppresses the synthesis of FSH and LH, creating a barrier to ovulation. The progestogenic substance included in contraceptives increases the viscosity of cervical mucus, inhibiting the movement of sperm. A change in secretory transformation creates all the conditions that doctors call granular regression, a condition where fertilization is almost impossible. These two processes occur simultaneously, and drugs used to create conditions under which granular regression affects the female body are divided into several types in modern pharmaceuticals for ease of use.
Is it necessary to take a blood test before taking the pills?
The selection of birth control pills is carried out by doctors, who are guided by test results regarding the body’s reaction. One of these tests is blood donation, which includes two types of diagnostics:
- The condition of the body based on a general blood test.
- Determining the balance of hormones (testosterone, progesterone, prolactin, etc.)
If problems arise regarding a negative reaction of the body, or in order to select other drugs, specialists may additionally prescribe blood tests for:
- Blood glucose.
- Determination of organ parameters, especially the liver (protein, albumin, bilirubin).
- For biochemistry to determine the lipid spectrum.
- Determining the intensity of blood clotting.
It is mandatory for a woman who uses birth control pills to protect the body from an unplanned pregnancy to have her blood tested twice a year without prompting from medical workers. This preventive action will make it possible to find out the main changes that occur in her body under the influence of medicinal substances.
Is it possible to have sex if there is bloody discharge from birth control pills?
Bleeding while taking birth control pills indicates a hormonal imbalance in a woman’s body: this can manifest itself in a deficiency of gestagen or estrogen in the OC. Constant discharge between periods requires changing the contraceptive to a stronger substance, then the hormonal balance will be restored and the problem will resolve on its own.
At the time of instability of the hormonal balance, experts advise to refrain from intimacy, since it is not against the background of oral contraceptives that bleeding can be observed, for example, diseases of the reproductive system, or an infection can provoke such a manifestation.
