Intermenstrual bleeding , previously known as metrorrhagia , is uterine bleeding at irregular intervals, particularly between the expected menstrual periods. In some women, menstrual spotting between periods occurs as a normal and harmless part of ovulation. Some women experience acute mid-cycle abdominal pain around the time of ovulation sometimes referred to by the German term for this phenomenon, mittelschmerz. This may also occur at the same time as menstrual spotting. The term breakthrough bleeding or breakthrough spotting is usually used for women using hormonal contraceptives , such as IUDs or oral contraceptives , in which it refers to bleeding or spotting between any expected withdrawal bleedings, or bleeding or spotting at any time if none is expected. If spotting continues beyond the first cycles of oral contraceptive use, a woman should have her prescription adjusted to a pill containing higher estrogen : progesterone ratio by either increasing the estrogen dose or decreasing the relative progestin dose.
Combined Hormonal Contraceptives
Extended-cycle birth control pills: Is breakthrough bleeding more common? - Mayo Clinic
Specific advice for women who are amenorrhoeic, postpartum, post-termination, or post-miscarriage is summarized in the section Amenorrhoea, postpartum, termination of pregnancy, or miscarriage. If the woman is not currently using a regular method of contraception or using a barrier method such as condoms :. If the woman is switching from another COC, the combined contraceptive patch, or the combined vaginal ring:. Symptoms associated with the hormone-free interval HFI can be problematic and ovarian activity during a 7-day HFI could risk escape ovulation particularly with lower doses of EE and if use is not perfect.
Breakthrough Bleeding When on Birth Control: What Causes It and When to Seek Medical Advice
Breakthrough bleeding—meaning spotting or bleeding between periods—can occur with any birth control pill, especially during the first few months of use. However, breakthrough bleeding is more likely with continuous and extended-cycle regimens—such as Seasonale, Seasonique, and Quartette—than with the traditional day schedule. Breakthrough bleeding can also occur when taking normal day birth control pills in a continuous manner. What causes breakthrough bleeding with oral contraceptives isn't always clear.
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