If breakthrough bleeding
continues beyond 3 months, and other reasons including poor adherence and pathologic processes are excluded, you could consider providing estrogen or switching to a different pill, though no clinical trials support definitive recommendations.
Interestingly, some studies of the Norplant System suggested small, potential improvement of breakthrough bleeding
after treatment with progestin; however, these effects were weaker than those seen with use of nonsteroidal anti-inflammatory drugs (NSAIDs).
Over the six cycles, the median number of days of breakthrough bleeding
was 57 in the mifepristone group, compared with 26 in the placebo group; this difference was statistically significant.
is a very common side-effect and only rarely a sign of anything seriously wrong.
trachomatis is implicated in the breakthrough bleeding
among DMPA users, a cross-sectional study compared endometrial biopsies from 20 women with bleeding and 20 women who were amenorrheic, Dr.
3% of women on Estrostep dropped out due to breakthrough bleeding
was reported by more women in the continuous treatment group (13%) than in the cyclic group (7%) (P = .
episodes were reported more frequently by the Seasonale Lo group than the Levlite group (13.
However, because women on Seasonale only have four periods a year, there is an increased chance of breakthrough bleeding
The common breakthrough bleeding
and spotting that occurs during the first 3 months of Seasonale use "is not medically consequential, but it can be very lifestyle consequential," Dr.
For women who experience unscheduled bleeding while taking an OC continuously, one option is to stop taking pills when breakthrough bleeding
occurs and initiate a hormone-free interval.
Although women may appreciate the added convenience of having fewer periods, they should be prepared for a higher incidence of breakthrough bleeding
than is usually seen with standard 28-day oral contraceptives, said Dr.
l Some women on a lower dose Pill may get breakthrough bleeding
and need a higher dose of oestrogen.
If breakthrough bleeding
extends beyond 4 cycles and a woman wishes to continue using an oral contraceptive, consider switching to a pill with a higher ethinyl estradiol:progestin ratio, either by increasing the estradiol dose or by decreasing the relative progestin dose
The ad fails to mention that patients using Seasonale may experience breakthrough bleeding
or spotting for up to a year, according to the letter.