Breakthrough Bleeding on Birth Control: What to Know

Hormonal birth control methods are among the most reliable forms of contraception when it comes to preventing unintended pregnancy. While that’s definitely a benefit, these forms of birth control are also associated with a type of abnormal bleeding called “breakthrough bleeding” — spotting or bleeding that occurs between your normal periods.

At his practice in Newburgh, Indiana, Paul Morrison, M.D., helps women understand the cause of abnormal bleeding, including breakthrough bleeding associated with contraception. Here’s what he wants his patients to know about breakthrough bleeding and how it’s treated.

Why breakthrough bleeding happens

Breakthrough bleeding sounds scary, but it’s actually quite common and, in most cases, not associated with a serious medical problem. As noted, it’s mostly associated with hormonal contraceptive methods, like birth control pills, vaginal rings, hormonal intrauterine devices (IUDs), birth control patches, and implants.

Your hormones control your menstrual cycles, so it shouldn’t be surprising that methods that use these hormones can also cause unusual fluctuations in bleeding, including breakthrough bleeding or spotting between periods. In most cases, breakthrough bleeding is lighter than a regular period, ranging from very sporadic or infrequent spotting to a heavier flow.

Breakthrough bleeding is especially common during the first few months of initiating a new form of hormonal birth control — whether it’s your first time using hormonal birth control or when swapping one method for another. Skipping a pill, not changing your patch, implant or ring on schedule, or using some other medications at the same time can also result in breakthrough bleeding.

What to do about breakthrough bleeding

First, if you have breakthrough bleeding, call the office to let us know. In most cases, especially if you’re beginning a new type of birth control or you’ve skipped a dose, we recommend continuing to take your birth control method while monitoring your bleeding for any changes. 

In these instances, abnormal bleeding usually stops on its own. If it recurs, we may discuss alternative forms of birth control with a different “dose” of estrogen or progesterone.

However, if your bleeding is quite heavy, if it recurs or persists, or if it’s accompanied by extreme cramps, fever, nausea, dizziness, back pain, or other symptoms, we may recommend an office visit right away so we can evaluate you for other potential causes, like ectopic pregnancy or infection.

Remember, once you begin using a birth control method, it’s essential to use it consistently, both to prevent unintended pregnancy and to reduce the risk of breakthrough bleeding. If you skip a pill or miss your schedule for other forms of contraception, give us a call before having sex for further instructions to ensure your method remains effective.

Don’t ignore abnormal bleeding

Even though breakthrough bleeding is typically harmless, it’s still important to let our team know. If you have breakthrough bleeding, give us a call so we can decide if you need to have an evaluation to confirm the underlying cause.

To learn more about breakthrough bleeding or contraceptives, call 812-490-5200 or book an appointment online with the practice of Paul W. Morrison, M.D., today.