How To Manage Breakthrough Bleeding When On Birth Control

Breakthrough bleeding — sometimes referred to as spotting — affects many people who are taking birth control, especially within the first few months of use (via WebMD). But wait a minute, you might be saying. Isn't birth control designed to help regulate menstrual bleeding? If so, how is it that breakthrough bleeding can still occur?

As it turns out, bleeding that occurs unexpectedly between periods is not all that uncommon when it comes to birth control use. However, how mild or heavy one's spotting may be can vary from person to person depending on a number of factors, such as the form of birth control one is using. This can include progestin-only oral contraceptives, estrogen-progestin combination pills, hormonal intrauterine devices (IUD), a birth control shot or implant, skin patches, or vaginal rings (per Healthline). Overall, low-dose birth control pills, the birth control implant, and hormonal IUDs pose the highest risk for breakthrough bleeding.

If you're using any one of these contraceptives and experiencing breakthrough bleeding, here are some tips for how you can best manage it.

Additional factors that may increase one's risk for breakthrough bleeding in relation to birth control use include smoking, taking your birth control pills inconsistently, use of an emergency contraception pill, or a diagnosis of STDs such as gonorrhea or chlamydia (via WebMD). Individuals taking a new supplement or medication, as well as those with gastrointestinal disorders who experience frequent vomiting or diarrhea, may also be more susceptible to breakthrough bleeding, according to Healthline.

For those new to taking birth control pills, breakthrough bleeding may simply need time to sort itself out. "It may take three months for your body to get used to the medicine and the lining of your uterus to adjust to it," Dr. Jacques Moritz, ob-gyn at New York-Presbyterian and Weill Cornell Medicine, explains to Self. This can also be the case when transitioning from a brand name birth control pill to a generic version.

Time may be all you need when it comes to hormonal IUDs as well, as spotting is considered common during the first three to six months of use. Those with copper IUDs in particular may experience breakthrough bleeding for even longer stretches of time.

For some people taking certain types of birth control, time may not be enough to manage breakthrough bleeding. For example, individuals on birth control containing minimal doses of estrogen, or pills that are completely estrogen-free, may benefit from switching to a higher-dose pill. This is because without adequate levels of hormones, the blood vessels in the uterine lining are more prone to breakage, increasing one's chances for spotting (via Self). However, it's important to note that high-dose hormonal birth control pills can come with more side effects. Talk to your doctor if you're interested in trying a different form or dosage of birth control — they will be able to advise on the best alternatives for you.

Aside from changing the hormone dosage of your birth control pills, you can also help reduce the likelihood of breakthrough bleeding by sticking to a daily scheduled time for taking your birth control, avoiding smoking, trying an alternate form of birth control altogether, or stopping birth control use for a brief period of time to allow your body to fully discharge the uterine lining, thereby reducing the risk of spotting (per WebMD).

While there's generally no reason to panic when it comes to breakthrough bleeding, in the event that bleeding increases in severity or lasts longer than a week, be sure to speak with your physician.