Medically reviewed by Sophia Yen, MD, MPH – Written by Pandia Health Editorial Team. Updated on December 18, 2020

So you’ve decided to start your #PeriodsOptional journey, and you are using birth control to skip your period. You’re excited to live your new period-free life. But a few months later, breakthrough bleeding has messed up your plans.

What causes breakthrough bleeding or spotting while you’re on birth control — and how do you prevent it? There are many reasons a faint version of Aunt Flo will knock on your uterus door and the good news is that it’s simple to get rid of her!

If you didn’t know that making your #PeriodsOptional was possible, now you know! Want to learn how to skip your period safely and effectively? Check out our webpage and our CEO/Co-Founder, Dr. Sophia Yen’s, TEDxBerkeley talk on periods optional! You can skip your periods using the birth control pill, ring or patch. Sign up today to get FREE delivery.

What is Breakthrough Bleeding?

Breakthrough bleeding is spotting or bleeding which occurs between periods. It’s usually a lighter bleed than your usual flow levels, but in some cases, it can be the same.

Breakthrough bleeding commonly occurs if you switch to a new type of hormonal birth control, take an over-the-counter cold medication that revs up your liver and eats some of the birth control hormones, or if a new person with a uterus “infects” you with their period. Your internal hormones are fighting back the birth control hormones and they won’t back down until you have a period.

Sanitary Pad With Blood

Forms of birth control with low ratios of estrogen to progesterone are often to blame for this issue. It could also be the type of progesterone in the birth control pill, patch, or ring that is the problem. Estrogen is needed to grow the lining of the uterus (the endometrium) while progesterone helps to maintain and nourish it. Thankfully, the hormone balance should sort itself out eventually.

What causes breakthrough bleeding?

Breakthrough bleeding can have a variety of causes. If you have been using birth control for an extended period of time, your body may need to adjust to having the hormones that it contains consistently.

How long does breakthrough bleeding last?

The length of breakthrough bleeding varies from person to person, but it should not last for longer than a week.

Periods are Optional!

One explanation for why you get breakthrough bleeding is because your body wants you to — while Pandia encourages you to take control of your body, sometimes it reacts without us knowing why. However, a clearer reason is due to human error — maybe you forgot to take your daily pill! According to a 2017 survey, 16% of women aged 15 to 44 years reported missing two or more pills — so you’re not alone, my friend!

How to stop breakthrough bleeding

Try not to panic or get frustrated at the red spots in your underwear. While it may be surprising, the good news is that there is a solution, it just may require some patience. If you’ve taken at least three weeks of active pills, to stop breakthrough bleeding, all you have to do is come off of the medication for five days; on day six, whether or not you are still bleeding, just begin taking the active pills again. The breakthrough bleeding will stop.

To treat breakthrough bleeding or spotting while on the pill, patch, or ring Dr. Yen suggests you try 600mg ibuprofen WITH Food for up to 3 times a day for up to 5 days MAXIMUM. Make sure you don’t have any kidney problems and that you drink eight glasses of water per day.

To Skip the Bleed

If you’re spotting and haven’t taken at least three weeks of active pills, continue taking them until you reach the end of the third week — it may sound like a longer process but it’s better to be on the pill than pregnant! Once you hit the end of that third week, simply go off the medication and let your uterus bleed.

If you try to fight it by not consistently taking the pill, it’ll just make it worse. By getting to week three and skipping the other pills for five days, your uterus will reset. Between 30 to 50% of people using combination birth control pills experience breakthrough bleeding and spotting in the first three to six months of use; this drops to 10 to 30% by the third month. The more consistent you are with taking your pill at the same time every day the more likely it is for breakthrough bleeding to stop. If you are still experiencing breakthrough bleeding speak with your doctor about other ways to stop the unscheduled bleeding.

First time Skipping your Period

2020 Calendar Hanging on Wall

The first time you skip your period with the pill or the ring, you may experience breakthrough bleeding or spotting after two to three months. As you continue the cycle of taking the medication for three weeks and coming off of it for five days, that stretch of time between bleeding and not will lengthen. You may have to repeat the process in 6-8 months if you begin spotting again. That means eventually, you will not have a period at all!

When to worry about breakthrough bleeding?

However, there are a few causes of breakthrough bleeding that are more serious. For example, if you are experiencing diarrhea and vomiting it may be because the pill hasn’t been absorbed properly or you may have taken certain medications that have interacted with the pill; smoking can also make spotting and breakthrough bleeding more likely. These instances are typically nothing to worry about but if you feel uncomfortable, consult with a doctor.

Pandia Health is the most trusted provider for birth control delivery, boasting an exceptional team of doctors who can prescribe your birth control online through a telemedicine consultation. The next step is getting your contraceptive method of choice delivered for free — even if you are uninsured! 

Check out this video for more information on spotting and breakthrough bleeding! And be sure to subscribe to the Pandia Health YouTube channel for more content like this!

Frequently Asked Questions about Breakthrough Bleeding

What does breakthrough bleeding look like?

Breakthrough bleeding typically appears as traces of blood on your underwear. It probably will look similar to your normal period blood, although in most cases it will be lighter.

How many days does breakthrough bleeding last?

The length of breakthrough bleeding depends on the person. However, it should not last longer than seven days. If you are experiencing breakthrough bleeding while taking birth control continuously, it is best to go off of birth control for a week to let your uterus reset.

Can stress cause breakthrough bleeding?

In some cases, stress can trigger breakthrough bleeding, as it can affect our hormones. The stress can be emotional or physical.

What color is breakthrough bleeding?

Breakthrough bleeding will typically be the same color as your normal period blood (red or dark brown).

How to stop breakthrough bleeding on the pill immediately?

The best way to resolve breakthrough bleeding is to go off of the pill for a week. This will reset your uterus. Then, resume taking birth control, and the bleeding should go away.

How to stop breakthrough bleeding from missed birth control pills?

Make sure to take your birth control pills consistently to avoid breakthrough bleeding. It might help to set an alarm or to always take it at exactly the same time every day so you do not forget.

The above information is for general informational purposes only and is NOT a substitute for professional medical advice. Always seek the advice of your doctor/primary care provider before starting or changing treatment.