Breakthrough Bleeding: What it is & 5 Ways to Cope

Red spotting on underpants

You’re in between periods and suddenly, you notice a reddish/brownish colored discharge in your underwear. What’s going on? Chances are, what you’re experiencing is breakthrough bleeding.

What is Breakthrough Bleeding?

Simply put, breakthrough bleeding refers to bleeding or spotting in between your periods. It’s not uncommon, and many women will experience this from time to time. Typically the bleeding is very light and presents itself as more of a pink or brown discharge rather than period-flow bleeding.

If the bleeding gets heavier or doesn’t stop within a day or two, it’s likely your period and not breakthrough bleeding that you’re experiencing.

What Causes Breakthrough Bleeding?

Red spotting on underpants

The most common cause for spotting in between periods is oral contraceptives. If you’ve just started taking birth control, you may experience some bleeding in between your normal period.

Typically, this type of bleeding is brought on by excessive estrogen levels. The body produces estrogen each day, and this hormone is responsible for regulating the shedding of the uterine lining. When you start taking oral contraceptives, you’re increasing your estrogen levels, and the body is provided with two sources of this hormone. Excess estrogen levels can then lead to spotting in between periods.

The good news is that this spotting typically only occurs during the first two cycles and resolves itself relatively quickly. Sometimes, women may also experience this bleeding when taking other hormonal contraceptives.

Breakthrough bleeding is also caused by a thick uterine lining. Although not life threatening, bleeding can be unpredictable and sometimes, lengthy.

You may also experience spotting around the time of ovulation because of hormonal fluctuations. An injury may also cause bleeding in between your period.

[Read more about Ovulation]

While not as common, you may also experience breakthrough bleeding during pregnancy. Bleeding is very light and only lasts, at most, a day or two. What happens is pregnancy hormone levels may not be high enough yet to prevent your period, which can lead to breakthrough bleeding.

What are the Signs and Symptoms of Breakthrough Bleeding?

Breakthrough bleeding is also known as spotting. The most common symptoms include:

Pink discharge on tampon
  • Blood-tinged discharge in between periods
  • A light blood flow, or light bleeding in between your periods

Typically, any bleeding in between periods will fall under this category, although there are other, more serious causes that may also be leading to bleeding (more on that shortly).

Should You Be Worried?

Generally, spotting in between periods is nothing to be concerned about, especially if you’ve just started taking oral contraceptives. If you’re taking birth control, the problem should resolve itself within one or two cycles.

However, if you experience any of the following symptoms, see your doctor right away:

  • You experience spotting in between periods for three or more cycles
  • The bleeding lasts for seven or more consecutive days
  • You experience bleeding for three weeks or more
  • The bleeding you’re experiencing is unusual compared to your typical menstrual cycle

Breakthrough Bleeding and Pregnancy

Some women experience no bleeding at all during their pregnancy, while others will have some spotting. If you’re pregnant, the sight of blood may make you panic, but it may not necessarily mean that you’re having a miscarriage.

It’s not uncommon for pregnant women to experience breakthrough bleeding around the same time they would normally get their period. We talked about this earlier, but the bleeding may be caused by changing hormones. Pregnancy hormones suppress your period, and sometimes, hormone levels aren’t quite high enough to do that yet. This can cause some bleeding and the symptoms that you normally experience just before you get your period (cramping, backache, etc.).

Breakthrough bleeding can stick around for first three months of your pregnancy. After this point, the placenta will take over and start producing the hormones for you. It’s important to note that there are some women who experience spotting all throughout their pregnancy and still give birth to a healthy baby under the watchful eye of their doctor.

[Read more about Miscarriage]

Diagnosing Breakthrough Bleeding

Whether you’re pregnant or have just started taking oral contraceptives, your doctor can confirm if the bleeding is breakthrough bleeding.

If you’re concerned about your spotting or bleeding, do not hesitate to see your doctor. It may be caused by a more serious condition.

How to Stop Breakthrough Bleeding – 5 Ways to Cope

Different types of spots on white background

Breakthrough bleeding can be managed, and in some cases may not need any treatment at all. Remember, spotting can be normal during pregnancy and when you begin taking oral contraceptives.

Here are 5 ways to manage breakthrough bleeding:

1. Adjust Your OC or HRT Medications

If you’re taking oral contraceptives (OC) or hormonal replacement therapy (HRT), stopping the bleeding may be as simple as adjusting the dosage of your medication. It can take as long as 6 months for the body to adjust to the medication, but if you experience bleeding beyond this point, ask your doctor to adjust your dosage.

2. Find Time to De-Stress

If you have irregular cycles and frequently experience spotting in between your periods, taking time to de-stress can help regulate your cycle. Stress is a leading contributor to period irregularity, so make some time for yourself. Relax, read a book, meditate or try yoga. Also, make sleep a priority. Getting an appropriate amount of sleep will help regulate your hormones.

3. Don’t Stop Taking Your Pills

If your bleeding is caused by birth control, don’t stop taking your pills abruptly. Many women assume that if they stop taking the pill, the bleeding will stop. But this will only make matters worse. For starters, it will put you at risk for getting pregnant. And when you do start taking the pill again, you’ll probably start bleeding again.

Quit smoking word written with broken cigarette concept for quitting smoking

It’s important to give your body time to adjust to the pill, so continue taking the pill as normal. Eventually, the problem will resolve itself.

4. Quit Smoking

Smoking is never a good idea, but the risks are amplified when taking birth control. There’s already an increased risk of blood clot and stroke when on the pill, and that risk is even greater if you’re smoking.

Plus, women who smoke are already more likely to experience spotting in between periods. If OC is the cause of your bleeding, quitting smoking can help prevent breakthrough bleeding.

5. Eat a Healthy, Balanced Diet

Hormone levels are often influenced by the foods that you eat. Eating a healthy, balanced diet will help regulate hormones. Meals that are high in sugar lead to insulin spikes, which suppress a protein known as SHBG (sex hormone binding globulin). This protein binds to excess testosterone and estrogen in the body, and when levels of this protein are low, sex hormone levels increase.

As you know, excess estrogen can lead to breakthrough bleeding. Rather than cutting out all sugar (which is next to impossible), try balancing your meals and lowering your glycemic load.

Breakthrough bleeding is often no cause for concern. If you’re on birth control, spotting in between periods is common and should disappear on its own within a few months. If you’re pregnant, this type of bleeding is also common, but you should see your doctor to make sure nothing else is causing the bleeding. If your bleeding is abnormal and you’re concerned, do not hesitate to speak with your doctor right away.


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