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Breakthrough bleeding is spotting or bleeding outside of a menstrual period due to hormonal contraception use. It can occur at different stages and may be influenced by the birth control method. Treatment depends on the cause, and if symptoms worsen, further medical evaluation may be necessary.
Typically, breakthrough bleeding refers to spotting or bleeding that occurs as the body adjusts to hormonal dosages from contraceptive use. Also, breakthrough bleeding is menstrual bleeding that occurs outside the normal time frame of a menstrual period, and the pattern is influenced by the birth control method itself. Typically, breakthrough bleeding can occur at different stages of birth control use, such as when starting the regimen or when trying to switch brands. Most of the time, however, the bleeding stops on its own and usually lasts only one or two cycles. For the most part, the bleeding is just a light spot, however it can be heavy.
Not all women using hormonal contraception experience breakthrough bleeding, but it is more common in smokers. The hormones responsible for breakthrough bleeding are progesterone and estrogen, taken alone or in combination. Although contraceptive hormones are often taken in oral form, breakthrough bleeding can occur when hormones are used in other forms. Different forms of hormonal contraception are subcutaneous implantation of a contraceptive device, injection and patches. Additionally, the devices can be inserted directly into the vagina, such as a vaginal ring contraceptive device.
While breakthrough bleeding is usually the result of the body self-regulating in response to the absorption of estrogen and progesterone, there are other causes of breakthrough bleeding as well. Even in the absence of hormonal methods of contraception, natural levels of circulating hormones can fluctuate, causing bleeding. Additionally, a decline in thyroid function can also cause this, as can dietary changes and weight fluctuations. Sometimes, drugs such as anticoagulants can be responsible for abnormal uterine bleeding because they interfere with platelet aggregation, which causes the blood to become thinner.
Generally, treatment for abnormal uterine bleeding depends on the cause. If the bleeding is related to birth control, the doctor may adjust the amount of hormones given or switch the patient to a different method of contraception altogether. The doctor may also recommend that the patient stop smoking in an effort to reduce or eliminate bleeding between periods.
Typically, if the bleeding or abnormal spotting gets worse or is accompanied by pain, vaginal discharge, or weakness, it may indicate a more serious medical condition. Usually, in this case, it may be recommended that the patient undergo further medical evaluation. Doctors will want to rule out infection, abnormal thyroid function, or even gynecological malignancy.
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