A side effect such as bleeding when taking birth control pills is very common when using oral contraception. Since the invention of tablet contraception, its popularity has not ceased to grow every year. The main advantages of this method of protection include ease of use, effectiveness, and the absence of the need to use barrier or spermicidal methods of protection.
Despite the fact that this group of drugs is being improved every year, bleeding while taking contraceptive medications is a common complaint among patients. The main types of bleeding from the genital tract while taking tablet contraceptives, their characteristics and methods of treatment will be discussed in detail below.
How do oral contraceptives work?
The key contraceptive mechanism of such oral contraceptives as Jess, Qlaira, Yarina, Regulon and Janine is to suppress the process of maturation and release of the egg. This effect is achieved due to the inhibition of the pituitary gland's production of gonadotropic hormones that regulate the ovulation process. In addition, the effect of tableted hormonal drugs is due to the following effects:
- They affect the degree of viscosity of cervical mucus, as a result of which the cervix becomes impassable for sperm.
- They change the structure of the mucous membrane of the uterine cavity, as a result of which the process of implantation of a fertilized egg becomes impossible.
- They influence the motor ability of sperm, making them immobilized.
Combined oral contraceptives contain progestogen and estrogen components. Under the influence of progestogens, the process of maturation and release of the egg is disrupted, and under the influence of estrogens, changes occur in the endometrium that do not allow a fertilized egg to implant. If a woman develops menstrual-like bleeding while taking tablet contraceptives, the cause may be a change in the balance of sex hormones, as well as additional factors of a physiological and pathological nature.
Causes of the phenomenon
Perhaps bleeding when using one or another oral contraceptive can be called a very common and unpleasant side effect of this type of drug. Insignificant, mild bleeding when taking OCs is very likely at the stage of the body’s adaptation to these tablets.
For 10% of women, the adaptation period can last six months. But there are still approximately 5% of girls who experience bleeding even after addiction is completed. Moreover, repeated replacement of products also does not eliminate the negative side effect.
However, why are such phenomena observed? A woman’s menstrual cycle is a chain of sequential changes associated with significant changes in the concentrations of hormones in the blood. In the first stages of the cycle, estrogen is produced in larger volumes.
The maximum concentration of this hormone in a girl’s body is observed on the days of ovulation, and then, if conception does not occur, it gradually decreases. Simultaneously with the fall in estrogen levels, there is an increase in the concentration of progesterone - it is he who is responsible for the rejection of the endometrial layer in the uterus. The latter process is manifested by menstruation.
In other words, nature made sure that the female body produces different concentrations of hormones during different phases of the cycle. It should be noted that all OCs today include small doses of active substances, and such a volume may initially simply not be enough to cover the natural level of these compounds. That is why a certain period (adaptation) is necessary so that the woman’s body gets used to small dosages of hormones and does not reject the endometrial layer earlier than the expected period (that is, before the completion of the capsules in the contraceptive package).
When, while taking a new OC, blood is released in an insignificant volume, and intimate hygiene requires only a few daily pads per day, there is no point in taking any measures, since often the body itself copes with such a side effect of the drug. Such discharge does not pose a threat to a woman’s health, and its presence during the first three months of use does not require discontinuation or replacement of the OC.
In addition, it must be emphasized that the presence of such bleeding does not reduce the contraceptive effect of OCs. The only thing you should not forget about is taking your pills on time. Moreover, the release of blood does not become an obstacle to intimacy if both partners do not neglect the rules of personal hygiene
It is extremely important to understand that there are no “good” or “bad” contraceptives, but there are those that are suitable or not suitable for a certain representative of the fair sex. But what to do if minor bleeding is observed even after the adaptation period has ended?
So, when addiction is complete, and slight blood loss is observed in the initial phase or in the middle of the cycle, this indicates a low dosage of the estrogen component in the OC, so it is likely that the problem will be solved by selecting a product with a higher content of this hormone.
If adaptation is complete, and bleeding in the middle of the cycle or towards its end continues to be observed, it makes sense to think about the deficiency of the gestagen component. This means that you need to start taking the drug with a more powerful dose of gestagen. However, if the discharge does not disappear and, on the contrary, intensifies, and is also accompanied by pain in the lower abdomen, you should not delay a visit to the gynecologist.
Possible causes of discharge when taking approx.
There are several key factors that may cause bleeding while taking hormonal pills. These factors include:
- Adaptation of the body and stabilization of hormonal levels. Regulatory intake of estrogen and progesterone from the outside inevitably leads to changes in hormonal levels in the female body. That is why, when a woman takes birth control pills, her periods occur in the middle of the cycle.
- Skipping the next dose. If for some reason a woman does not take her next contraceptive pill, she may experience bleeding from the genital tract.
- Single or multiple cysts in the ovarian area. Cystic formations often lead to breakthrough bleeding when taking birth control pills. This condition is urgent and requires immediate medical intervention.
- Preservation of ovulatory function. For some women, it is normal for a slight spotting to occur during egg maturation. If, for one reason or another, ovulation persists while taking contraceptive tablets, then the woman may experience this symptom. In addition, if the ovulation process continues, there is a risk of unplanned pregnancy.
What does bleeding at the beginning and end of a dose indicate?
If the adaptation period has passed, but brown discharge in the form of a spot persists, this may mean that the chosen contraceptive is not suitable for the woman. In such a situation, it is necessary to replace the drug used with another one.
When a girl takes pills from the beginning or middle of the package, and spotting brown discharge occurs, this indicates an insufficient concentration of estrogen in the drug. In such a situation, it is necessary to select OCs with a higher content of this hormone. For example, if such discharge is detected when taking the micro-dose contraceptive Jess, a drug from the group of low-dose COCs (Yarina) is prescribed.
If bleeding occurs in the middle of the cycle or when taking the last pills from the package, this may mean that the woman does not have enough progestin component. In such a case, a drug with some other gestagen is prescribed.
Types of discharge after birth control
The characteristic acyclic bleeding after taking birth control pills is conventionally divided into several types, depending on the period of occurrence of this symptom. The main types and characteristics of vaginal intermenstrual bleeding while taking contraceptive tablets will be discussed in detail below.
Adaptive
If a woman bleeds when taking birth control pills at the very beginning, then we are talking about the so-called adaptation bleeding associated with a change in the balance of sex hormones in the body. The normal range for the duration of the adaptation period is 2-3 months . As a rule, the discharge disappears on its own without drug correction. If the bleeding does not stop after 5 months while taking hormonal birth control pills, the woman needs to change the contraceptive or choose an alternative method of contraception.
In the middle of the cycle
The main cause of bleeding in the middle of the menstrual cycle while taking tablet contraceptives is estrogen deficiency in the female body. Another common factor is the incomplete period of adaptation of the woman’s body to new dosages of hormones.
In this situation, the woman needs to consult her gynecologist in order to identify the cause of the bleeding. In this case, a comprehensive gynecological examination will be required, including laboratory and instrumental methods.
Withdrawal bleeding
After finishing taking tablet contraceptives, a woman may experience bleeding from the genital tract of varying degrees of intensity.
Often, spotting at the end of taking tablet oral contraceptives is breakthrough in nature and is abundant. If the volume of discharge is insignificant, then we are talking about the normal process of restoring female hormonal levels after discontinuation of the drug. As a rule, characteristic spotting appears in a woman 1-2 days after stopping the medication. In 50% of women who stop taking contraceptives, the discharge disappears on its own after 1.5-2 weeks. The duration of bleeding from the genital tract after discontinuation of contraceptives is influenced by factors such as the woman’s age, as well as the total duration of the period of taking the medication.
After emergency contraception
After using emergency contraceptive pills, women in 50% of cases experience bleeding from the genital tract. The reason for the development of this symptom is the synthetic gestagen levonorgestrel, which is part of postcoital contraception. This substance changes the ratio of hormones in the female body, leading to temporary disruption of menstrual function. The normal duration of bleeding in the middle of the menstrual cycle while taking Postinor or another emergency contraceptive is no more than 7 days.
If the discharge does not go away after 5-7 days, then the woman is advised to urgently consult her gynecologist.
It is important to pay attention not only to the duration, but also to the volume of discharge. If the frequency of changing sanitary pads is more than 1 pc. per hour, then we are talking about opened bleeding. This condition is a reason for emergency hospitalization.
Common causes of pathology
Bleeding often occurs while taking oral contraceptives under the influence of the following factors:
- addiction of the female body;
- incorrect choice of dose of the main active ingredient.
The norm is the appearance of light bleeding during the first three cycles. The body needs to rebuild. With contraceptives, estrogen enters the body. Your own estrogen also continues to be produced. A sharp increase in the level of the substance leads to the development of bleeding.
Gradually, the hormonal system gets used to the supply of additional substances. Your own estrogen stops growing to its usual level. The body stops reacting sharply to taking the pills. The bleeding disappears on its own.
Pathological bleeding is also observed when the dose of the main active ingredient is chosen incorrectly. Each woman has an individual hormonal background. If the pills do not contain enough estrogen, the system may not respond to such a contraceptive. In this case, the woman experiences continuous spotting.
How to stop bleeding from birth control pills?
If a woman bleeds while taking birth control pills, the nature of the help depends on the duration and intensity of the discharge. If the discharge is of a spotty nature, and its duration does not exceed the physiological norm, then the woman does not require specialized help or take any additional medications. Hemostatic medicinal tablets are necessary if the bleeding is breakthrough in nature. Heavy discharge lasting more than 7 days is a good reason to visit your gynecologist .
If a woman experiences intense uterine bleeding, which is accompanied by a deterioration in her general condition, then the primary task is to call an ambulance. Before the team arrives, the woman should be placed on her back, a rolled-up blanket or pillow should be placed under her straightened legs, and a heating pad with ice or another source of cold should be applied to the suprapubic area. Such measures will make it possible to reduce the intensity of bleeding by narrowing the blood vessels. In addition to bed rest and cold, you can offer the woman warm tea with added sugar.
It is strictly forbidden to use unfamiliar medications to stop bleeding on your own, as well as apply any heat source to the abdominal area. In addition, showering and bathing are prohibited.
In order to stop uterine breakthrough bleeding, the following names of medicinal drugs are used:
- Dicynone or Etamsylate. Both drugs have a similar mechanism of action, leading to accelerated production of thromboplastin. Medicines are intended for intramuscular administration.
- Aminocaproic acid. If it is necessary to urgently stop bleeding, aminocaproic acid is administered intravenously. In the absence of an emergency need, the drug can be prescribed in tablet form.
- Oxytocin. This substance is a hormone that stimulates the contractility of the smooth muscles of the uterus. Oxytocin solution is intended for intravenous drip administration with glucose solution. Stopping bleeding occurs due to intense contraction of the uterine muscles.
If bleeding between periods when taking hormonal pills is not breakthrough in nature, but continues longer than prescribed, then patients are often prescribed calcium gluconate and the drug Vikasol, which is a concentrated solution of vitamin K. In case of breakthrough bleeding, these drugs are ineffective.
Character of bloody discharge
Non-menstrual discharge mixed with blood may differ in the nature of its manifestations. Experts advise paying attention to the density (viscosity), the abundance of bloody veins and their color. This will help determine the nature of their occurrence and, if necessary, begin treatment of the problem.
Blood smears
Mucous discharge from a woman’s genitals during the intermenstrual period is normal for a young female body. If the presence of a small amount of blood is observed in the mucous membrane after starting to take oral contraceptives, when the discharge is “smeared” and by external signs everything resembles the beginning of the menstrual cycle, you need to wait a little time, since the body most likely has not yet adapted to the new hormonal changes.
These manifestations can be called a normal reaction of the body to the presence of a substance in the drug that does not suppress one of the types of hormones. According to the color format, the discharge may appear light pink or brown; its discharge may not always remain on the laundry, and is only noticeable if toilet paper is used. If spotting is observed 2-3 cycles (months) after starting to use oral contraceptives and the bleeding remains stable, but then stops, the phenomenon is considered normal.
Breakthrough bleeding while using birth control
If breakthrough bleeding is observed after using OCs, this indicates that the endometrium, under the influence of the hormone (progesterone), is not perceived by the uterus due to the small amount (insufficient for uterine bleeding) of estrogens. Bleeding of this kind can also occur while taking other medications. This type of bleeding is an undesirable form of manifestation and requires action to eliminate it, both from doctors and the patient herself.
When should you see a doctor?
Every woman's body is individual. Some patients use oral contraceptives for many years without experiencing any negative reactions. Another category of women experiences the slightest changes associated with taking hormonal contraception. There are certain situations that are an absolute reason to seek medical advice. Such situations include:
- Bloody discharge from the genital tract bothers a woman for more than 7 days.
- The discharge is profuse when a woman is forced to change sanitary pads or tampons more often than once every 1.5-2 hours.
- The discharge is accompanied by a deterioration in general condition, dizziness, nagging or aching pain in the suprapubic region.
If, from the moment she started taking tablet contraception, a woman experiences periodic bleeding from the genital tract for more than six months, then she is recommended to consult her gynecologist for advice. As an alternative, a different name for the tablet drug, or a complete replacement of the method of protection against unplanned pregnancy, may be offered.
Discharge from the mammary gland
The mammary gland should not react to the use of hormonal contraceptives; discharge from birth control pills is not typical for it.
Galactorrhea appears as a consequence of the disinhibition of the hormone prolactin, which most of the time is under the inhibitory effect of dopamine. The surge in prolactin that leads to breast milk must be coupled with decreased estrogen levels. Rarely, with stress, depressive disorders, or during the use of COCs, clear discharge from the mammary glands appears. To establish the cause of the condition, a full examination is needed . Sometimes white discharge from the breast after stopping OK is a harbinger of a breast tumor.
