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The bleeding is usually light, often referred to as "spotting," though a few people may experience heavier bleeding. [citation needed] It is estimated that breakthrough bleeding affects around 25% of combined oral contraceptive pill (COCP) users during the initial 3 to 4 months of use, it then usually resolves on its own. [8] [9]
Implantation bleeding. "Implantation bleeding is thought to be light bleeding that occurs about 10 days after ovulation," says Washington, D.C.-based ob-gyn Dr. Cordelia Nwankwo. This type of ...
The spotting you're noticing might be implantation bleeding (a.k.a. when the fertilized egg attaches to the uterine lining) or even just the early stages of pregnancy itself.
Unscheduled bleeding that occurs during such hormonal treatment is termed "breakthrough bleeding" (BTB) Breakthrough bleeding may result from inconsistent use of hormonal treatment, although in the initial months after initiation of a method, it may occur even with perfect use, and may ultimately affect adherence to the medication regimen. [27]
It is thus a progesterone withdrawal bleed. As there is no progesterone in the anovulatory cycle, bleeding is caused by the inability of estrogen—which needs to be present to stimulate the endometrium in the first place—to support a growing endometrium. Anovulatory bleeding is hence termed 'estrogen breakthrough bleeding'.
Implantation bleeding may be confused with a regular period. [ 3 ] [ 4 ] Heavy vaginal bleeding in the first trimester or bleeding associated with pain, may be a sign of a complication , such as a miscarriage or an ectopic pregnancy , that would need to be assessed by a healthcare provider.
While unpredictable breakthrough bleeding is a possible side effect for all hormonal contraceptives, it is more common with progestogen-only formulations. [16] Most regimens of COCPs, NuvaRing, and the contraceptive patch incorporate a placebo or break week that causes regular withdrawal bleeding.
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