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Breakthrough Bleeding: Why it happens & When to talk to your Doctor

What is Breakthrough Bleeding?

Basically, breakthrough bleeding is vaginal bleeding that happens in the middle of your cycle or at any other time not during your period.

Any vaginal bleeding that takes place when you are pregnant is considered breakthrough bleeding. Furthermore, although breakthrough bleeding occasionally occurs and is anticipated, it can also be an indication of a more serious condition, particularly in postmenopausal women.

As you might have suspected, determining the specific reason for the ailment is essential to treating it. Causes include hormonal birth control, the morning-after pill, STIs, and hormonal imbalances.

Breakthrough Bleeding: Why Does It Happen?

There are many causes of breakthrough bleeding, they can be broken down into two categories: hormonal causes and structural causes. The most likely causes are stress and not taking a birth control tablet on certain days.

Causes of Breakthrough Bleeding linked to hormones include:

  • Birth control methods that use hormones, such as a vaginal ring, skin patch, hormonal IUD, implant, or injection. Within the first few months after starting a new hormonal birth-control technique, breakthrough bleeding is relatively common.
  • Inconsistent birth control pill dosage
  • The use of emergency contraception
  • Menopause or perimenopause
  • Polycystic ovarian syndrome (PCOS)
  • Endometriosis
  • Miscarriage
  • Vaginal infections, such as yeast infection or trichomoniasis

Even though infections are a disruption in the ratio of bacteria to yeast brought on by a deficiency or imbalance in hormones, Vaginal infections are regarded as hormonal reasons rather than structural causes. For instance, menopausal women are more susceptible to vaginal infections because decreased estrogen alters the balance of microorganisms in the vagina.

Structural causes of Breakthrough Bleeding may include:

  • STIs, such as chlamydia.
  • Vaginal lesions.
  • Polyps.
  • Uterine fibroids.
  • Fragile cervix.
  • Cervical cancer, womb cancer, or vaginal or vulvar cancer
  • Prolapse.
  • Ovarian cysts.

Rough sexual interaction or lifestyle changes like stress or weight reduction can also result cause it.


Breakthrough Bleeding on Birth Control: Is It Normal?

It’s also possible to get breakthrough bleeding if you take your birth control tablets erratically. Hormone levels in the blood fall when a medication is missed. You receive a predetermined daily dosage of estrogen and progesterone via the pill. The body interprets a missed or late tablet as a warning that a withdrawal bleed is necessary since you are approaching the end of your active hormone supply and the beginning of a placebo week.

Breakthrough bleeding is also possible if you take the pill constantly without a monthly placebo week that starts a menstruation. The likelihood that you will finally break through and get a period increases the longer you go without letting the body shed the lining it produces. This often doesn’t occur until four to six months have passed after your last menstruation. The lining builds up the entire time and does not shed, which makes it more difficult for hormones (pill) to control it from shedding.

The good news is that even if you suffer breakthrough bleeding, your birth control still works to prevent pregnancy.

Breakthrough Bleeding: When to talk to a Doctor

Most breakthrough bleeding is minor and usually goes away on its own with time, particularly if it’s brought on by your body having to adjust to hormonal birth control or by being under stress. However, you should see a doctor if any of the following apply to you:

  • Heavy Bleeding
  • Painful Bleeding
  • Over 5 days of bleeding
  • Bleeding during Pregnancy
  • Postmenopausal bleeding
  • Bleeding outside of your normal pattern
  • Bleeding during STI


The reason for breakthrough bleeding determines the course of treatment. Although many ovarian cysts may not require surgery and will naturally heal, if your doctor concludes that the reason is structural, such as a fibroid, ovarian cyst, or polyp, you may need surgery to remove the structure.

Your doctor may request blood tests if your bleeding is hormone-related in order to pinpoint the exact reason and may prescribe medication if required. If it has to do with your birth control, talk to your doctor about trying a different technique, such as a monthly contraceptive rather than a continuous-use one or one with a slightly greater hormone dose.

In conclusion, breakthrough bleeding frequently resolves on its own, but if it persists or causes you any concern, it is better to consult your doctor to identify the root of the problem. There are treatment alternatives that might assist you in avoiding the inconvenience and worry that can result from this ailment.

Visit the Whispa App to start a chat with a Doctor.

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