Many women today are able to control their own family planning by using contraception. A very common form of contraception is oral birth control pills. These are easily available in consultation with your healthcare professional. Birth control pills contain synthetic hormones estrogen and progesterone in varying amounts to suppress ovulation. During the non-drug or placebo days, you experience bleeding which you view as your period. However, sometimes bleeding occurs during the "active-drug" phase of your cycle. This breakthrough bleeding can cause distress and confusion.

Is It Normal to Experience Bleeding While on Birth Control Pill?

There are two types of normal vaginal bleeding while you’re on an oral contraceptive:

• Menstrual bleeding: Normal menstruation occurs during the 5-day placebo period. At this time, the levels of active synthetic hormones are reduced in the body and the body is able to expel its uterine lining.
• Breakthrough spotting: Spotting or breakthrough bleeding occurs during the time you’re on active hormonal tablets. Although this is unexpected, it is not very unusual. It involves a very small amount of blood that a panty liner can usually contain.

Note

It is important to note that women on oral contraceptives develop periods that are light and last for only a few days. Therefore, a large volume of blood loss or bleeding over a long period of time can be indicative of other more serious condition. In this case, see your doctor immediately. Spotting longer than seven days per cycle or spotting for more than four months consecutively needs medical attention.

Why Am I Bleeding While on Birth Control Pill?

There are many explanations why spotting occurs:

• Breakthrough spotting can occur during the first few months of commencing the pill or changing the type of birth control pill. Your body requires some time to adapt to these different levels of synthetic hormones.
• Spotting occurs when you forget to take your daily dosage as prescribed and miss a few doses. If this has occurred, then the contraceptive power of the birth control pill has been compromised and other birth control methods should be used.
• Hormonal imbalances can be incompatible with the particular type of birth control pill your healthcare professional has chosen for you. This is easily rectified by choosing another type of oral contraceptive.

There could also be some serious reasons for bleeding while on birth control pill:

• Sexually transmitted diseases like chlamydia and gonorrhea can cause vaginal bleeding. Untreated sexually transmitted diseases can develop into severe symptoms.
• Other undiagnosed vaginal infections can also be the cause. Often infections are undiagnosed because they exhibit no overt symptoms like redness, itching or burning during urination. These types of infections can be diagnosed during a Pap smear or cervical exam.
• Fibroids and tumors may also be the source of unexplained bleeding while on birth control pill. Seek medical attention to either rule out these causes or get the correct treatment.
• Medication interactions can cause spotting. Some medicines, like antibiotics, interfere with the efficacy of the oral contraceptive.
• Some medical conditions likediabetes and heart disease can affect the manner in which the synthetic hormones work in your body.

How to Prevent Bleeding While on Birth Control Pill

1. Take Your Pills at the Same Time

The most common reason why women experience breakthrough bleeding is that they have missed more than one dose. Read the instructions carefully to see what you have to do in the case of missed doses. If only one dose is missed from monthly packs, then just take that missed dose when you remember in addition to the normal daily dose. Taking two pills on one day is fine. Any more missed doses may increase your risk of getting pregnant. In this case, you will be advised to use another form of contraceptive like condoms until the next packet of pills.

2. Follow the Correct Sequence

Contraceptive pills are carefully manufactured and packaged to maintain the efficacy of the synthetic hormones they contain. Each pill is protected in its plastic blister in the correct sequence to help you track which pill needs to be taken next. Follow this sequence carefully to prevent bleeding while on birth control pill and possible failure of the contraceptive. Therefore, you should not pop the pills from their blisters until you’re ready to take them. Storing your pills as per the manufacturer’s guidelines will also help to preserve the integrity of the synthetic hormones in the pills.

3. Avoid Smoking

Bad habits like smoking, when in combination with oral contraceptives, can lead to serious complications like stroke, blood clots and liver tumors. Spotting can occur in women who smoke and are on oral contraceptives because smoking increases the estrogen metabolism, thus lowering the levels of estrogen. 

4. Keep Healthy Weight

Sustain a healthy weight because being too overweight or grossly underweight can affect your body’s hormone levels and thus the body’s metabolism. This can lead to abnormal levels of the synthetic hormones from the pill, which can result in bleeding while on birth control pill.

5. Reduce Stress

Control any stress you may experience. Use relaxation and breathing to control the effects of stress on your body. Stressful situations lead to higher than normal levels of cortisol in the body. This cortisol affects the efficacy of oral contraceptives and can lead to breakthrough spotting.

6. Talk to Your Doctor About Supplements

If you take any herbal supplements or vitamins, ensure that they’re not affecting the efficacy of the hormones in the pills. Some supplements like St John’s wort have been known to interfere with the absorption of the synthetic hormones into your body. Speak to your doctor or pharmacist about what supplements and vitamins are safe to take concurrently with your contraceptive pills.