Don't make spots equal sprogs.

December 3, 2007 10:12 PM

Strange cycle question. May be TMI

So, about seven days before my period, I get a mini-period, and have for several months now. I'm on the pill, and have been for a while, so this is very odd. Why am I bleeding and lightly cramping? Ortho-Tricyclen has otherwise been very good to me, but now I worry that the contraceptive properties of the medication I take every morning aren't protecting me.

What are my options? What will my doctor (who I must obviously seek out) do? I kind of liked this form of birth control and I don't trust myself with condoms as the only shield, so I want to make sure I reduce the chance of wee little Phalenes at this stage in my life, without giving up one of life's most pleasurable activities.

As for a background to the spotting: The month before my first incident I had my first pill mishap in a year and ate two pills in one day (I woke up, took my pill, went back to sleep, woke up a couple of ours later, said 'OMG, forgot pill!' and spent the rest of that month with terrible breakouts and mood swings). Not knowing what else to do, I took pills as usual until I finished the pack and then waited until the day I normally start a new pack, adding an extra day off to my messed up cycle.

The next month and the three after I’ve been taking my pills on time, and bang on schedule comes a fake, very light period on day 19 out of 28, that vanishes by day 21, only to have my regular period hit at around 4:00 PM on day 24 (often with cramps on the 23rd night).

posted by Phalene to health (13 comments total)

You are most likely experiencing breakthrough bleeding, which is very common on hormonal contraceptives. Your contraception is still effective, so don't freak out!
posted by DarlingBri at 10:16 PM on December 3, 2007

I had the same problem with breakthrough bleeding and didn't want to switch pills. My doctor gave me a prescription for an extra dose of the same estrogen that was in my pill, to bump it up a bit at certain times of the month. As I recall, when in your cycle you have breakthrough bleeding makes a difference in when you need an extra dose of hormones, as well as which kind (estrogen vs. progestin), so it's great that you've kept track of that.

DarlingBri is right that you don't need to freak out — your pill is still working, it's just that breakthrough bleeding is annoying. If it annoys you enough that you want it to stop, just because it annoys you, you have options. Just talk to your doctor.
posted by adiabat at 10:25 PM on December 3, 2007

Definitely go see your doctor to make sure this is still the right option for you. IANAD, but DB looks right. It could be some form of breakthrough bleeding that may or may not have occurred as a result of your missing a pill. I was on Ortho-Tricyclen for about four years. If you've been on the pill for that long or somewhere close, then the bleeding may be a result of your body becoming really adjusted to that that particular form of BC.
posted by inconsequentialist at 10:28 PM on December 3, 2007

When you say you take them on time, do you mean the exact same time every day? The last time I was on the pill, I'd have breakthrough bleeding if I wasn't meticulous about that.
posted by Ruki at 10:35 PM on December 3, 2007

@Ruki Same time every day, for two years. When I went out of my timezone I even faithfully kept my watch on local time and calculated the difference, even if it meant waking up at 2:00 AM, gulping a pill and going back to sleep.

@adiabat I don't mind needing a liner for two days, so I don't think I'll ask for a dose.

@Everyone. I want to best answer you all. :D
posted by Phalene at 10:45 PM on December 3, 2007

As a former OB/GYN nurse, breakthrough bleeding isn't really unusual, but it also depends on how long you've been on this pill and how long this has been happening. You mention "for a while" but that's rather vague. Generally speaking you shouldn't have breakthrough bleeding all that often. If you do, then the dose most likely needs adjusting.

I'll agree though with the others that you're still covered as far as contraceptives, so no worries. It's just that you'll also being to experience mood swings with breakthrough bleeding, not to mention other problems (nothing earth shattering, just little stuff and some risks), so it's important to have the right balance.

Another poster was also right as far as missing pills and having breakthrough bleeding, although on the other hand, it's very unlikely to only miss one pill and have breakthrough. It's usually after a couple of days OR if you routinely skip one day, like take one day, forget tomorrow, remember the day after and skip the next one too. That kind of thing.

Good luck to you! Cycle's are a pain, and I mean that seriously. ;)
posted by magnoliasouth at 12:29 AM on December 4, 2007

I had the same problem on ortho-tricyclen. OBGYN switched me to Apri (which has the added bonus of clearing my face). Breakthrough bleeding in week 3 has all but stopped.
posted by beachhead2 at 8:51 AM on December 4, 2007

Correct me if I'm wrong, but Ortho Tri-Cyclen is one of those that has three different dosages, right? And your spotting is coming during one of the dosage changes? This doesn't seem terribly odd to me, which isn't really useful but hopefully will reassure you more before you can get to the doctor.
posted by anaelith at 8:56 AM on December 4, 2007

I had something like this for years while I was on the pill. I was told it was breakthrough bleeding and something I would "just have to get used to" by one Ob/Gyn, and ignored it. When it got worse, I went to another doctor, and, to make a long story short, I had endometriosis. Eventually, I had to have a total hysterectomy.

Obviously, that's a worst-case scenario, and lots of other answerers had different experiences. Still, I would check with your doctor if it continues and is a monthly thing for very long, either to try a stronger contraceptive or check for anything more problematic.
posted by misha at 9:08 AM on December 4, 2007

that happened to me! it was so annoying. it stopped when i switched to a monophasic pill. you might want to try a different progestin, too....the doc can advise you better.
posted by thinkingwoman at 9:12 AM on December 4, 2007

I had symptoms very similar to yours and ended up having a small ovarian cyst. My doctor initially thought it could have been breakthrough bleeding due to missing pills, but sent me for an ultrasound anyway, which found the cyst. Cysts usually break on their own eventually, but sometimes they take some time to do that. Are your cramps all on one side?

Track your cycle as best you can (looks like you're doing a good job already), and go to your doctor with those stats. Then they can decide if it's a pill thing, or a something-else thing.

Good luck, and I hope it sorts out soon.
posted by melissa at 11:17 AM on December 4, 2007

Here’s another vote that it might be something a bit more serious than your pill. I had mild to moderate breakthrough bleeding about a week before starting my period, similar to what you describe, for about six months. I talked to my doctor about it on numerous occasions, but she just kept shrugging it off as a normal result of taking a low hormone pill. Then one day I out of the blue I started hemorrhaging. Not just having a heavy period, but pouring blood non-stop. It lasted for about 24 hours until it was brought under control by taking extra doses of hormones, but by then I had lost so much blood I was very weak and anemic, and I had to have a blood transfusion. It turned out to be caused by a fibroid. Now I’m on lots of hormones to control the bleeding, and I’m going to need surgery eventually. I wish that I had been more insistent earlier that someone check out the origin of the bleeding so I could have avoided the hemorrhaging ordeal.
posted by c lion at 12:16 PM on December 4, 2007

Suddenly this feels a lot more scary. My aunt has fibroids (late forties female) and I want to have babies some day so I want my plumbing to work. :(

I get back cramps, which feel like angry kidneys. Always have, and front cramps are very rare. Mood remains normal (my PMS predates breakthrough bleeding and is pretty mild).
posted by Phalene at 1:04 PM on December 5, 2007