How long is too long to be "spotting" on Seasonale?

July 14, 2009 9:27 PM

How long is too long to be "spotting" on Seasonale?

I've been on oral contraceptives for about a year now. I started primarily to stem the tide of the horrific cramps that I get during the first 2-3 days on my period. It only worked a little. So, two months ago, on recommendation from my primary care physician, I switched to Seasonale, in hopes of eliminating cramps by eliminating periods.

I was fine for the first five weeks, when I basically had a full-blown period, cramps and all. It's been over two weeks now (normal period length is about 5-6 days), and I'm still bleeding as much as I would be if having a normal, not-on-birth-control period, and cramping worse than when I hadn't been on birth control. I anticipated spotting, and even a little bit of cramping, but I'm starting to worry.

My question is this: it's been two weeks. When do I need to make an appointment and/or arrangements for alternative birth control? Is this normal for other Seasonale users?

posted by anonymous to health & fitness (7 answers total)

When I saw this post, I thought I had written it and then forgotten! I have just ended an 18-day period that started 4 1/2 weeks into my first cycle on Seasonale, after about a year on the Pill that didn't make enough of a difference in my lengthy, blood-bath periods.

I just saw my doctor today, and she very firmly wants me to stay the course. Apparently, up to 20 days of spotting or bleeding is normal during the first Seasonale cycle (the package insert even says so), and she remains optimistic that if I stay on it, I should see big improvement before too long. She said she would be surprised if I had anything like this next month, and that things will probably settle down significantly in the second 90-day cycle.

As far as alternative methods of birth control go, I am not using Seasonale for birth control, so I'm not sure how the spotting/bleeding affects its efficacy for that.
posted by not that girl at 9:32 PM on July 14, 2009 [1 favorite]

Same story here. I was prescribed Seasonale and had pretty heavy spotting for about 4 weeks. Then at the end of my first 90 day cycle, I had a pretty heavy "period". After that I have had no problems, and have been taking Seasonale for 3 years now.

I would give it another 2 weeks or so, and if you don't see any improvement check with your doctor.

Also, are you taking your pill first thing in the morning? If so, try and switch to taking it at night before you go to bed. I was getting pretty nauseous taking it on an empty stomach in the mornings and taking it at night eliminated that problem.
posted by lootie777 at 9:47 PM on July 14, 2009

Sounds pretty normal. The old Seasonale website was really upfront about the side effects but it looks like they redesigned the site and made it harder to find. Anyway, check out this PDF, page 14, for the stats--basically 35% of women had 20 or more days of spotting in the first 90 days, 15% had 20 or more days of spotting per 90-day cycle after a year on the pill, and 8% said "screw this" and dropped out of the study due to the side effects.

If things continue rough you might also want to consider asking your doctor about switching to Seasonique, which is just Seasonale slightly tweaked to attempt to reduce the side effects.
posted by phoenixy at 10:10 PM on July 14, 2009

I also had spotting on Seasonale, and from what I remember, it's pretty common when you first start off with it. If the amount of blood worries you, definitely speak with your care provider. If it's truly just spotting, bust out the panty liners and hold the course until your body adjusts.

Also, I remember paying outrageous prices for it when I was on it, since it hadn't gone generic yet. If you're doing the same, I'd suggest talking to your provider about just switching to a monophasic BCP (I'm on the generic Apri, which costs $5 a pack) and stacking them for 3 months at a time, so you're on continuous hormones instead of taking the placebo weeks. It brought my 3-month pill prices down from $125 to $15.
posted by scarykarrey at 8:33 AM on July 15, 2009

(FYI, there are currently generic versions available of Seasonale--Quasense and Jolessa. Seasonique is not out as a generic yet, there's a lawsuit going on over the generic version.)
posted by phoenixy at 9:12 AM on July 15, 2009

If things continue rough you might also want to consider asking your doctor about switching to Seasonique, which is just Seasonale slightly tweaked to attempt to reduce the side effects.

The difference between Seasonale and Seasonique is that the latter replaces the 7 sugar pills with low-dose estrogen. This is supposed to make your withdrawal bleed lighter (withdrawal bleeds when you're on an extended-cycle regimen can be biblically heavy) and otherwise reduce the side effects you would experience during your placebo week only. It won't have any effect on breakthrough bleeding while you're taking the regular pills.
posted by thisjax at 1:45 PM on July 15, 2009

Same as everyone else, I spotted for about the first 30 days of Seasonale, then never had a problem again. I've been taking it for 5 years.

(Actually, I switched to the generic, Quasense, when it became available 2 years ago, and have experienced no changes).
posted by srrh at 6:36 PM on July 15, 2009