Why am i bleeding after my period on birth control

Q: When should I be worried about breakthrough bleeding?

Its important to tell your doctor if your bleeding is particularly heavy or if you notice spotting or bleeding after sex. While breakthrough bleeding may be normal and go away on its own over time, you should call your doctor if youre also experiencing: abdominal pain. chest pain.

Table of Contents Show

Hormonal contraceptives
Other causes
When to seek medical advice
Further information
Why am I bleeding again after my period on birth control?
When should I be worried about breakthrough bleeding?
Why am I bleeding a week after my period ended?
How long should breakthrough bleeding last?

Q: Is it natural to have prolonged periods after just starting birth control? I started taking the pill when I started my period and it still persists.

A: Irregular bleeding is the most common side effect of birth control pills. It is especially common during the first three months as your body adjusts to the hormones in the medication. However, other things (like sexually transmitted infections) can cause prolonged bleeding too. If the bleeding is especially heavy (more than a normal period), persists throughout the whole month or occurs only with intercourse – especially if you’ve stopped using condoms – you should see your women’s health care provider to make sure nothing more serious is going on.

The most common cause of irregular bleeding is missed pills, so make sure you are taking the pill every day, and at the same time every day.

Birth control pills can cause a lot of other side effects, especially bloating, nausea and breast tenderness. Most side effects resolve after a few months, but the clinicians in our Women’s Services Department usually recommend that you check in with your health care provider after your first 3 months on the pill to make sure everything is going OK. If you have any questions or concerns about birth control, they’re happy to answer them for you.

John A. Vaughn, MD
Student Health Services
The Ohio State University

There are many different causes of bleeding between periods. Some may not be anything to worry about, but seek medical advice if you're concerned.

Hormonal contraceptives

Irregular bleeding, such as bleeding between periods, is common during the first few months of starting hormonal contraception, such as the:

combined oral contraceptive pill
progestogen-only contraceptive pill
contraceptive patch (transdermal patch)
contraceptive implant or injection
intrauterine system (IUS)

If you're concerned about bleeding or it lasts longer than a few months, you should seek medical advice.

You may also bleed between periods if you:

miss any combined pills
miss any progestogen-only pills
have a problem with your patch or vaginal ring
are on the pill and are also sick or have diarrhoea

Other causes

Some other causes of bleeding between periods include:

taking the emergency contraceptive pill
injury to the vagina – for example, from having penetrative sex
recently having an abortion – seek medical advice if you're bleeding heavily
sexually transmitted infections (STIs) such as chlamydia – it's a good idea to get tested if you've recently had unprotected sex with a new partner
recently having a miscarriage
reproductive hormones not working normally – this is common in women approaching the menopause or in women with polycystic ovary syndrome (PCOS)
stress
vaginal dryness
harmless changes to the neck of the womb (cervix) – this may be called cervical ectropion or cervical erosion
cervical cancer – if you're aged 25 to 64, you should be having regular cervical screening tests to detect any changes to your cervix; even if you're up-to-date with screening tests, you should see a GP about irregular bleeding, particularly bleeding after sex, to eliminate the possibility of cervical cancer
womb (uterus or uterine) cancer – this is more common in post-menopausal women and most cases of endometrial cancer are diagnosed in women over the age of 50; see a GP if you're over 40 and have bleeding between periods to eliminate the possibility of uterine cancer
vaginal cancer or vulval cancer
cervical or endometrial polyps – non-cancerous (benign) growths in the womb or the lining of the cervix
fibroids

When to seek medical advice

If you're concerned about bleeding between periods, you should:

see a GP
visit a sexual health or genitourinary medicine (GUM) clinic

A healthcare professional will talk to you about your symptoms. Depending on your situation, they may suggest doing some tests, such as:

tests for STIs, which may include an examination of your genitals
a pregnancy test
a cervical screening test, if you're aged 25 to 64 and not up-to-date with these
a pelvic ultrasound scan

To diagnose some conditions, you may need an examination, such as:

a speculum examination – a smooth, tube-shaped tool (a speculum) is inserted into your vagina to examine your vagina and cervix
an internal examination of your vagina with gloved fingers (bimanual examination)

Find out the answers to more questions about women's health

Further information

Heavy periods
Period pain
Stopped or missed periods
Find services: sexual health

Page last reviewed: 5 November 2019
Next review due: 5 November 2022

Why am I bleeding again after my period on birth control?

Spotting or bleeding between periods (breakthrough bleeding) can occur with any birth control pill, especially during the first few months of use. However, breakthrough bleeding is more likely with continuous and extended-cycle regimens than with the traditional 28-day schedule.

When should I be worried about breakthrough bleeding?

It's important to tell your doctor if your bleeding is particularly heavy or if you notice spotting or bleeding after sex. While breakthrough bleeding may be normal and go away on its own over time, you should call your doctor if you're also experiencing: abdominal pain. chest pain.

Why am I bleeding a week after my period ended?

Some women may have blood remaining in their uterus after their period has ended. In such cases, the uterus may contract to remove the blood. As the old blood is forced out, these contractions can cause cramping and brown or black spotting.

How long should breakthrough bleeding last?

Breakthrough bleeding can last a few days, or can occur just as a light spotting. But if breakthrough bleeding lasts more than seven days, you should see your doctor.