What is breakthrough bleeding?

It can be alarming to have vaginal bleeding when you’re not expecting it, but there are various causes of spotting and in many cases it can be nothing to worry about. That said, it’s always a good idea to talk to a healthcare professional if you have questions or concerns about your reproductive health.

Breakthrough bleeding on the pill and other contraceptives

Breakthrough bleeding isn’t just a side effect of being on the pill. Many types of hormonal birth control methods, including rings, shots, patches, IUDs, and the implant, can cause breakthrough bleeding – particularly if you’ve just switched to a new method of birth control, missed a dose, or don’t use your birth control consistently.

If you’ve just had an implant or IUD inserted, or just started on the pill or patch, then you may find that you regularly have breakthrough bleeding for the first three to six months, until your body adjusts to the new hormone levels. 

This also applies to the copper IUD, which is a non-hormonal type of birth control, but it can still cause breakthrough bleeding while your body gets used to this new device.

If you’re taking any type of birth control pill, irregular bleeding can also be a common side effect, even after the adjustment period. That’s because intentionally skipping or accidentally missing pills can disrupt your hormone levels, which can cause breakthrough bleeding.

In all of these cases, your irregular vaginal bleeding will usually go away on its own over time – but it’s important to keep track of your bleeding and be aware of any other symptoms. If you also experience other issues like abdominal pain, heavy bleeding, leg pain, chest pain, or changes to your eyesight, call your doctor or healthcare provider.

Other causes of irregular bleeding

While breakthrough bleeding is a common side effect of hormonal birth control, there are a number of things that can also cause irregular bleeding. These include:

Infections

Some sexually transmitted infections, like gonorrhea and chlamydia, can cause unexpected bleeding. If you’ve had unprotected sex and have abnormal bleeding, you can rule out STIs with a quick check-up or at-home test.

Other types of infections and inflammatory conditions can cause unusual bleeding too, such as vaginitis, cervicitis, and pelvic inflammatory disease (PID).

If you have an infection or inflammation, you may also experience other symptoms along with breakthrough bleeding, such as cloudy urine, a burning feeling when you urinate, pelvic pain, and abnormal or foul-smelling vaginal discharge.

Endometriosis

Endometriosis is a long-term condition in which the tissue called endometrium grows outside the uterus, in the ovaries, fallopian tubes, abdominal cavity, bladder, or bowels.

It can be extremely painful and debilitating for some women, and irregular bleeding is just one of several symptoms, along with others including:

• Pain during menstruation
• Pain during sex
• Pelvic pain when not menstruating
• Painful bowel movements or urination
• Fatigue and low energy

Uterine fibroids

Conditions like fibroids, which are non-cancerous growths in the uterus, may cause bleeding, as can other uterine conditions like polyps (small growths on the uterine lining) and adenomyosis (when the tissue that usually lines the uterus grows into the uterine wall).

Some people with fibroids don’t have any symptoms, but among those who do experience symptoms, unscheduled bleeding is one of the most common. Other symptoms include pelvic pain, heavy periods, frequent urination, and back and leg pain.

Stress and lifestyle factors

If you’re going through a particularly stressful time in your life, you may find that it affects your periods. Your menstrual cycle may become longer or shorter, and you may also experience irregular bleeding. It can also be caused by other lifestyle factors such as sudden changes in weight, excessive exercise, or a big change in your daily routine.

Perimenopause

As women approach menopause, hormonal changes become more common. During this time, our periods can become less regular, and bleeding between periods can happen more often.

Early pregnancy

It’s not uncommon to experience bleeding in early pregnancy, which can be caused by a range of different things including:

• A sensitive cervix
• Implantation bleeding
• A subchorionic hematoma
• A miscarriage
• Ectopic pregnancy

When to see a doctor about breakthrough bleeding

In many cases, breakthrough bleeding isn’t anything to worry about. It’s a common side effect of hormonal birth control, particularly in the first few months of switching to a new birth control method, as your body adjusts.

However, irregular bleeding can sometimes be an indication of something more serious, so if you’re concerned or have other symptoms, then it’s important to speak to your healthcare provider to rule out other issues like STIs and uterine fibroids.

You should also speak to your doctor or OB-GYN if you have unexplained bleeding during pregnancy. It may simply be a result of a sensitive cervix rather than anything more serious, but it’s always a good idea to get it checked out.

Treatment for breakthrough bleeding

The first step is to identify the cause of your breakthrough bleeding. If it’s likely caused by hormonal birth control, like birth control pills, patches, or implants, then it may be a case of waiting a few months for it to settle down. However, sometimes breakthrough bleeding continues after the initial few months, in which case you should speak to your doctor about adjusting the type of birth control or the dosage.

If unexpected bleeding bothers you, you may want to consider switching to a non-hormonal birth control method. Methods like Natural Cycles are 100% hormone-free and are popular with people who’ve previously used hormonal birth control but didn’t enjoy the side effects, like irregular bleeding.

If you’re happy with your current birth control, then you should ensure that you use it as prescribed – especially if you’re on the pill. Taking it at the same time every day can help to regulate your bleeding, while missing or skipping pills can lead to hormonal fluctuations and spotting.

If your unexpected bleeding is due to an underlying condition like fibroids, then addressing the underlying cause should alleviate your symptoms. And if it’s caused by lifestyle factors or stress, then stress reduction techniques like meditation, exercise, and relaxation may help.

Take control of your periods with Natural Cycles

If you are interested in exploring a non-hormonal method of birth control, then Natural Cycles could be the right choice for you. It’s the first FDA Cleared birth control app, and is hormone-free and non-invasive. Whether you’re trying to avoid pregnancy or are actively planning pregnancy, Natural Cycles can help. Why not sign up and see if it could work for you today?