Unscheduled or breakthrough bleeding (BTB) is a common short-term side effect of hormonal contraception. Nevertheless it can be unexpected and disturbing to patients, who will often prematurely abandon their prescribed method without a back-up plan or notifying their physician. BTB occurs with contraceptive pills, patches, vaginal rings, injections, implants, and hormonal IUDs. For instance 10 to 30% of oral contraceptive users will experience BTB during their first month. This drops to less than 10% by the third month, and almost disappears thereafter.
Women who understand in advance that unscheduled bleeding commonly occurs during the first few months of hormonal contraceptive use are more likely to accept this transient nuisance without dissatisfaction and therefore less likely to discontinue use prematurely. This becomes even more important with extended use oral contraceptive regimens (eg. Seasonique®) where expectations run high, but reality falls short. Even with the new pill Lybrel®, the everyday “no period” pill, approximately 50% of women achieve perfection of no bleeding, but many experience unscheduled spotting amounting to far less bleeding than they would if they were spontaneously menstruating.
Let us remind you to call your doctor before discontinuing any prescription medications. BTB does not compromise safety or efficacy. One tip that helps many of our patients, especially busy teenagers, is to place pills by your tooth brush to associate taking them with an established evening habit. If you only miss one pill, one day, then take it ASAP, and contraceptive effectiveness will not be compromised. However, if you should miss two consecutive days you should not only take your missed pills, but also use a backup method (eg. Condoms with spermacide) for the remainder of your cycle.
Together we can help you meet your family planning goals.
Wishing you good health!
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Unscheduled bleeding does not compromise contraceptive effectiveness
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Women’s Health Specialists
2299 Mowry Ave. Suite #3C
Fremont, CA 94538