WOMENS-HEALTH Messages for August, 1997: Re: Breakthrough Bleeding On OCs

Re: Breakthrough Bleeding On OCs

From: D. Ashley Hill, M.D. (anonymous@obgyn.net)
Thu, 28 Aug 1997 21:23:45 -0500 (CDT)

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At Thu, 28 Aug 1997, Pat wrote: >
>Could you identify the reasons some women experience increasing
>breakthrough bleeding on birth control pills.

Pat-

I have found 2 main types of bleeding on women who take OCPs. The 1st, as you mention, is common after starting the pill and usually resolves after 3-4 months. This is probably from a destabilized endometrial lining as it responds to the change in hormones.

The other type is more troublesome, and occurs after being on the pill for many months or even years. I usually see irregular spotting throughout the cycle. Since OCPs are a little progestin-dominant the progesterone component "wins out" over time, and the endometrium thins out so much that it becomes raw (denuded). The raw, exposed vessels bleed a little at a time, causing troublesome spotting. The treatment is either to add estrogen, say 1.25 mg of conjugated estrogen per day for 10-14 days. An easier, but a little "riskier" treatment from a contraception standpoint is to simply stop the pill for 10-14 days then restart it on a Sunday. Both allow stabilization and regrowth of the endometrium.

Thanks,

Ashley

--
Ashley Hill
D. Ashley Hill, M.D.
Associate Director
Department of Obstetrics and Gynecology
Florida Hospital Family Practice Residency
Orlando, FL
I apologize, but I am unable to answer personal e-mail
due to time constraints.

Next message: John: "Tracking/notifying PAP Smear Patients electronically"
Previous message: Kelly: "Re: Fertile Window"
In reply to: Pat: "Breakthrough Bleeding On OCs"
Next in thread: Clyde: "Re: Seeking Advice"
Reply: Clyde: "Re: Seeking Advice"

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