If you experience spotting or breakthrough bleeding for an extended amount of time, schedule an appointment with your doctor. Your doctor needs to know if you have spotting or breakthrough bleeding for more than seven days of your cycle. In addition, spotting or bleeding that persists for more than four months warrants medical attention.  See your doctor for new episodes of spotting. The spotting or breakthrough bleeding may be caused by something unrelated to your birth control pills. If you are continuing on the same regimen of birth control pills but begin to experience mid-cycle bleeding, this may be a symptom of another problem and should be evaluated by your doctor. Breakthrough bleeding may be a sign of other problems including pregnancy or conditions involving cervical changes. If you have made lifestyle changes such as smoking, or have started taking new medications that may be interacting with the birth control pill regimen, this can cause breakthrough bleeding as well. Many birth control pills are made to contain the lowest possible amounts of some hormones. Your doctor may change your pills to a type that contains slightly higher levels of estrogen if he or she is aware of your ongoing problem with spotting. Changing to a pill formulated with a different type of progesterone, such as levonorgestrel, may also help.>  If you continue to have problems with spotting or breakthrough bleeding on your current pill, talk to your doctor about either switching to another strength or extending the number of days you take active pills vs the placebo pills at the end of most packs. There are many types of pills that are effective at preventing pregnancy. Finding the best one to suit the hormonal needs of your body is simply a matter of being patient and trying a few different types. Doctors routinely start with products that contain the lowest possible amounts of either estrogen, progesterone, or both. Changing to a brand with a slightly higher dose of estrogen usually stops the problem with spotting and breakthrough bleeding. Some packages are now designed to extend your days of active pills by taking advantage of a 3 month cycle as opposed to the usual 1 month pill pack. By switching to a 3 month cycle, you may have less trouble with your periods and fewer problems with spotting and breakthrough bleeding. Talk to your doctor about this option. Many women stop taking their birth control pills out of frustration due to continued problems with spotting or breakthrough bleeding.  Consider being patient and open to trying other types of birth control pills. Realize that stopping your birth control pills means you will need to find another method of birth control. Birth control pills are one of the most effective and convenient ways to prevent pregnancy. Other methods are often less reliable, inconvenient, and sometimes require interruptions during sexual intercourse. Your doctor will schedule your appointments at intervals felt to be most appropriate for your age and any risk factors you may have for other diseases. Many doctors may recommend scheduling your appointments on an annual basis to evaluate for changes and be sure your prescription birth control pills are at the best dose for you.  If you are having any problems with new or persistent bleeding, make an appointment as soon as possible for an evaluation. Vaginal bleeding can be a symptom of a medical condition, including some that are serious such as cervical cancer. In addition, your doctor may want to perform screening tests for sexually transmitted disease or other problems on a routine basis, possibly annually, depending on your personal circumstances. Birth control pills do not protect from sexually transmitted diseases. Let your doctor know as soon as possible if you think you may have acquired a sexually transmitted disease. Many drugs can interfere with the effectiveness of your birth control pills. Be sure your doctor has a list of all your medications. Continually update him or her on any changes that are made to your regular daily doses of prescription drugs, over-the-counter agents including aspirin and nonsteroidal anti-inflammatory drugs like naproxen and ibuprofen, vitamins, and herbal supplements.  Drugs that can interfere with the effectiveness of your pill can include everything from over-the-counter herbal supplements to antibiotics. Both short and longer term use of some antibiotics can alter the effectiveness of your birth control pills. If you are prescribed an antibiotic for any reason, it is important to let your doctor know since your birth control regimen may be less effective. Some antiseizure medications can also interfere with the effectiveness of your birth control pills. Seizure medications are sometimes used to treat mood disorders and chronic pain syndromes such as migraine headaches. Some herbal supplements, especially St. John's wort, may also interfere with hormonal birth control. Always ask your doctor or pharmacist about the need to use backup birth control when you are taking something new. Medical conditions can alter the way birth control pills work in your body and may put you at additional risk of unwanted complications.  Some medical conditions may warrant closer monitoring for women that are taking birth control pills. Examples include diabetes, a history of cardiovascular disease, and a history of breast disease. If you get a virus, the flu, or a stomach condition that includes nausea, vomiting, and diarrhea, let your doctor know. The symptoms alone can alter the absorption of your birth control pills. This means they are probably less effective during this time and you may need to use another method of birth control until you are feeling better for at least seven days.
اتصلي بطبيبك إن كنتِ تمرين بنزيف تبقيعي مستمر. اعتمدي نوعًا آخر من حبوب تنظيم النسل. تعاوني مع طبيبك. اخضعي لفحوصات منتظمة لعنق الرحم وتحليل عينات منه. تحدثي لطبيبك عن الأدوية الأخرى التي تأخذينها. أخبري طبيبك عن حالتك الصحية الحالية أو الأمراض التي ممرتِ بها في السابق.