Why do birth control pills cause spotting between periods?

Most women who take oral contraceptives get anxious if they notice spots of blood on their underwear between periods. There are a number of reasons for this and, in most cases, it ceases naturally. Sometimes, the causes can be more serious, e.g. thyroid problems, hormonal fluctuations, some medical conditions, and stress. Let’s have a closer look at this problem known as spotting.

During a period, the uterus sheds its entire lining. If some pieces are left behind, the body will automatically get rid of these remnants. This is why spotting is often brown in color – it is old blood. The correct medical term for spotting is breakthrough bleeding. It seems to be more evident in women who use combination pills.

‘Combination pills’ refer to oral contraceptives that contain two artificial hormones, namely progestin and estrogen. These pills can increase the density of mucus in the cervix area. This is to offer extra protection from the sperm getting to an egg. Combination pills also alter the lining of the uterus to prevent ovulation.

The pills stop ovulation but, if they are not taken according to the dosage directions, a hormonal imbalance may occur. This too is a common reason for spotting. Hormonal fluctuations are a common side effect of oral contraceptives. Often, after the body has got used to them, spotting stops completely.

Many women do not realize just how important it is to take the pills exactly as directed. They should be taken at the same time every day to ensure that the synthetic hormones are released into the system at a constant rate. If you take a pill three hours later than the scheduled dose, this variation can disrupt hormonal levels. Another common mistake, which is even worse, is missing a dose. Trying to ‘catch up’ by taking two the next day will only make the hormones more imbalanced.

On the day that you skip the pill, hormonal levels drop. Then, suddenly, they rise too much if you take a double dose the next day. Therefore, you have to be extremely conscientious about dosage. To avoid this problem, set a daily alarm on your cell phone to remind you. It is essential to keep hormonal levels stabilized. Never double up a dose without consulting your doctor.

Often, women have to change to a different type of oral contraceptive because of side effects, or the price. In this case, it is important to discuss your options with a medical doctor before switching to another pill. When you start the new pill, there will be some initial side effects, one of which could be spotting. Again, this is due to the fact that the body has to adjust to the synthetic hormones.

Combination pills are usually dispensed in 21 or 28 day packs. If you are going to change to a new brand, you must first complete the pack that you started. Commencing with a new pill halfway through the cycle can cause very unpleasant side effects. If you have not used birth control pills for some time and you start using them again, spotting is common.