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Hi Aunt Vadge,
I started bleeding about a week into my birth control pill pack, and still have bleeding. Light, like my period usually is, even lighter. I am almost at the end of this pack. I have not been sexually active for over a month, and did have a period after being sexually active last. Over the past two weeks, while the bleeding has occurred, I’ve had cramps and increased breast tenderness.
Could I be pregnant, or could this just be a hormonal issue from the pills or ovulation? I’ve only been on birth control for seven months.
Yours,
Unsure
Hi Unsure,
The short version: this is far more likely to be breakthrough bleeding from your pill than a pregnancy, especially as you haven’t had sex in over a month. The quickest way to put your mind at rest is a cheap home pregnancy test from any pharmacy or supermarket. They’re private, they cost a few dollars, and they’ll settle the question today. If it comes back negative and the bleeding stays light, you’re very probably just having a hormonal wobble.
Why the pill can cause this
On the combined pill, your usual monthly hormone cycle is switched off, so the ‘period’ you get in the sugar-pill week is really breakthrough bleeding, not a true period. Sometimes your body sits at a hormone level that lets you spot a little for days on end, particularly once you’ve been on the same pill for a while.
Your body always drifts back towards its own rhythm, so occasional spotting, and even the odd ovulation, can happen on the pill. That’s part of why the pill has a small real-world failure rate even with perfect use. If you ever miss two or more pills, use backup contraception for seven days afterwards, because ovulation can happen days later, not on the day of the missed pill itself.
Your symptoms don’t point to one answer
Tender breasts and cramping are frustratingly unhelpful on their own. Ovulation, a period and early pregnancy can all cause them, so they can’t tell us which one is going on here. That’s exactly why a test is worth doing, rather than reading the tea leaves from symptoms.
If the test is negative, you can usually let this ride out and see how things settle after your next pill-free week. Bodies do odd things now and then, from missed periods to double periods to mid-cycle spotting, and the occasional one-off is nothing to panic about.
If the pill keeps giving you grief
If this pill keeps causing trouble, it may simply not suit you anymore. Every pill is a slightly different hormone mix, so switching to another one can settle things down. Have a look at the contraception options here, and talk them through with a doctor or a family-planning or sexual health clinic. Plenty of those are free or low-cost if money is tight.
See a doctor sooner rather than later if the bleeding turns heavy, won’t stop, comes with real pain, or you get any bleeding after sex. That’s worth checking in person rather than waiting it out. Otherwise, do the test, keep an eye on things, and know this is usually easily sorted.
Warmest regards,
Aunt Vadge
This is general information and not a substitute for personalised medical advice. If the bleeding is heavy, doesn’t stop, or you’re worried, please see a doctor or nurse who can check you properly.
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