Breakthrough Bleeding

Breakthrough bleeding is a name for light menstrual bleeding, or spotting, between menstrual periods. This can happen when you are taking birth control pills.

Here are some common things that cause normal breakthrough bleeding and what you can do:

• Missing 1 or more pills: Read our handout “What If I Miss a Pill?” seattlechildrens.org/pdf/PE1466.pdf for information on what to do.
• Starting a new medicine or changed dose of a medicine you already take: Some medicines can interfere with the effectiveness of birth control pills. Call the nurse line at 206-987-2028, option 4. We may need to discuss switching your birth control pill or method.
• Taking your birth control pill at a different time each day: Try taking your birth control pill at the exact same time every day. Some people will set alarms on their cellphone or computers or put the pills next to something they use every day, like a toothbrush.
• Vaginal and cervical infection: Breakthrough bleeding can be due to a vaginal or cervical infection. Schedule an office visit with us to check for this.
• Starting a new birth control: Breakthrough bleeding is very common in the first 3 months of starting a new kind of birth control. If it lasts longer than that, make an appointment. We can discuss if a different dose or a different type of birth control would be better.

Sometimes heavy bleeding requires urgent or emergent attention. We may not be able to return phone calls or MyChart messages in the same day. You may need to go to urgent care or an emergency room (ER) if you:

• Have severe menstrual bleeding that soaks through a super pad or tampon in less than 1 hour and continues bleeding for 2 hours in a row, especially if you feel dizzy or very tired (severe fatigue).
• Lose consciousness.

Sometimes breakthrough bleeding can be heavier or need sooner attention. Call our office or send us a MyChart message to let us know about your bleeding. Include how long you have been bleeding and what menstrual products you have used or think you need.