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» Scarleteen Boards: 2000 - 2014 (Archive) » EXPERT ADVICE » Ask Scarleteen » Light to no withdrawal bleeds

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Author Topic: Light to no withdrawal bleeds
clairbaire123
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Is it common for women to have lighter withdrawal bleeds and then have no withdrawal bleeds on their placebo week after some time? My nurse told me thats common on the pill
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Heather
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Winding up with fewer or no withdrawal bleeds isn't common on the pill. That's a common side effect of Depo-Provera, the implant, and the Mirena IUD, but not the pill. It can happen with the pill, but it's not common.

However, lighter, shorter bleeds IS a common side effect with the birth control pill.

[ 02-14-2013, 10:36 AM: Message edited by: Heather ]

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clairbaire123
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I said I was on my third pill pack at the start of the conversation but I was mistaken, this is my fourth. The second pill pack I missed a pill and made it up but that placebo week I had a really heavy withdrawal bleed and since then my bleeds have been super light and my bleed hasnt shown up this pill pack. I took all my pills on time and have gotten some light spotting but was told thats not a concern by my OBGYN.

Im concerned because I like the assurance a bleed gives me. If I have taken all my pills and havent missed any do I need to take a pregnancy test every time my bleed doesnt show up? Thats a lot of money [Frown]

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Heather
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The combined birth control pill is 92% effective in typical use and over 99% effective in perfect use. That's in one year, so what I generally suggest to people, given that one year is a time to take pill *perfectly* that's pretty far out of reach for most people (as you've experienced yourself), is that folks using the pill alone, and doing it very well, should probably figure that in one year of use they've got something like 95-96% effectiveness over that year.

Only you can know if that's effective enough for you to feel comfortable trusting it alone. If it is, then I don't see a need for pregnancy tests if you haven't missed a withdrawal bleed. If you DO miss a bleed, and you have had the kind of sex (namely, intercourse) which poses a risk of pregnancy, testing is advised.

This likely isn't something you'll have to deal with every month, though, because you should not be missing withdrawal bleeds every cycle.

And, perhaps obviously, if it turns out you don't feel so comfy using the pill alone for any reason, then you can always use dual contraception, what we know works best to prevent pregnancy, by backing up with a second method, like condoms.

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clairbaire123
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How can I differentiate between a light withdrawal bleed and spotting during the placebo week?


A pregnancy test would be accurate on the day of a missed period? Say if the latest it comes is on sunday, can I take one on Monday morning?

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Heather
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Well, spotting is the term we use for light bleeding, so spotting during that week most likely IS a light withdrawal bleed.

Ideally, you want to test for pregnancy once a period is late, and since periods and withdrawal bleeds will tend to deviate by a few days often enough, in repro health "late" tends to mean around five days, give or take, after the LATEST day you'd expect a period.

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clairbaire123
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Oh I see, so if spotting occurs, then pregnancy testing isnt necessary because its most likely the bleed?

Just so I understand, if the latest it comes is sunday then I should test on Friday?

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Heather
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If you're using your pill properly, and you are also having withdrawal bleeding during the placebo week, then yes, it would be very unlikely for you to be pregnant.

But if you want to take a pregnancy test for your peace of mind, then we really can't say when a test is needed: that's up to you to decide.

And yep, you've got that timing right. That'd then be about the earliest you should test with most tests.

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clairbaire123
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Why do most tests say accurate first day of a missed period? That seems to be so misleading!!
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Heather
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Missed would mean you absolutely didn't get it. In other words, by saying that, they're not saying one day later than you expected your period IS a missed period.

They are saying that on the first day you're sure a period was actually missed, rather than just being late, that test can be accurate. Make sense?

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Heather Corinna, Executive Director & Founder, Scarleteen
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clairbaire123
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I understand. I never thought it was like that.

So since I missed a pill I'd probably be around the 92%? I would still fit in that percentage right, despite the tea concern? Im waiting on my bleed and I guess my anxiety is kind of override anything reasonable thinking at the moment. I know the tea isnt a big deal especially since I realize that duh, people in Europe and Britain drink lots of tea. I didnt take any late or missed pills and I followed the leaflet directions exactly. Im not sure if this counts as a pregnancy risk/assessment and I know you're implementing rules about that so I apologize. I don't mean to go against that if this falls under breaking the rules [Frown]

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Heather
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A missed period means we didn't get one in a given cycle. In other words, that we're moving into our next menstrual cycle, clearly, so we can know or be pretty sure we didn't get one in the last one.

Typical use effectiveness rates take into account a missed pill every now and then, but yes: if you've missed a pill, I'd err on the side of caution and figure you probably will be having typical use effectiveness, that 92%. So, again, if you want more effectiveness than that, then you'll need to either switch to a more effective method OR back up your pills with a second method.

We've already talked through your concern about the tea and made clear that's a non-issue, so let's let that one go, okay? And thanks for the care with our protocols. [Smile]

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Heather Corinna, Executive Director & Founder, Scarleteen
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Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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clairbaire123
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So light bleeding during the placebo week would be the withdrawal bleed and thats normal on the pill?
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Robin Lee
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Yes.

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clairbaire123
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Could you explain something to me pls? So typical effectiveness for the pill is 92% for the year right, so if one misses a pill do they have to take it perfectly for a year (no late/missed) to be back up to that 99%? Why do they say that a missed pill in a previous pack, if made up, does not affect the upcoming pill packs?
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clairbaire123
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and another question, do NaCl shots interact with birth control pills?
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Molias
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Any time you are prescribed a new drug, your doctor or pharmacist should warn you of any interactions - this is why it's important to let them know every drug you take - but if they don't let you know at the time you can just give a quick call to check. It seems unlikely to me that the shots would present an issue but if you're worried, you can certainly ask.

As to why a missed pill only impacts that current pill pack, it may help to read this: How do birth control pills really work, even during the placebo period? Essentially, every pack is its own cycle; even if you take a pill late, after your placebo/withdrawl bleed week, the next pack starts a new cycle; as long as you take your pills on time then, you're covered. Any issues from one pack don't carry over into the next.

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