“Bleeding while on birth control?”

Hello,

So, first of all: There is nothing wrong! The most common reason for a visit to the gynecologist is irregular bleeding. The number one treatment is the birth control pill, however, it usually takes awhile before the irregular bleeding to become regular. Try not to worry as irregular bleeding is very common and this is still "normal" for many people. I would give it about 6 months before considering changing birth control pills. 
I hope that this helps.

Joseph A. Adashek, MD FACOG

You need to be seen. You may have another condition: polyp, fibroid, etc., or on the wrong dose of cop.

My first question is did you have your hormone levels checked, male and female before you were started on birth control pills? Many times, patients are just ‘put on the pill’ before any investigation is ever done to see if there is a reason for the abnormal bleeding pattern. Granted, there are many patients who have abnormal periods and no pattern to their bleeding that birth control or oral contraception pills (OCP’s) can control. However, approx. 15-20% of women begin to manifest a condition of excess male hormone production called Polycystic Ovary (PCO) syndrome (PCOS) in their early years of their menstrual career with this male dominance in hormone becoming a stronger and more dominant pattern as patients progress out of adolescence into their 20’s and 30’s. It’s highly important to know if you may actually have PCO or PCOS because excess male hormone leads to mid abdominal weight gain (similar to what men have in their 50’s, 60’s and beyond), to excess facial hair to upper lip and chin, acne and sometimes cystic acne not only to their face but to their back (back-ne) or shoulders and excess hair loss, similar to male pattern baldness. In addition patients with PCO or PCOS have higher infertility rates as their female hormone levels are typically low and age inappropriate more often than their levels will be higher and age appropriate, showing the hormone swings that are more typical of a women in her mid to late 40’s in perimenopause before menopause. The bet way to know if you may have PCO or PCOS, which is genetic, is to have your hormone levels checked, even while you are on OCP’s. Ask your doctor to check your Estradiol, Progesterone, Total Testosterone and Free Testosterone levels; if your Free Testosterone levels are greater than 15th percentile of the normal range, then you may actually have PCO or PCOS and you need further work-up. PCO and PCOS patients usually require a higher dose of OCP’s (30, 35 and sometimes even 50mcg dose OCP’s) as the lower dose pills are not strong enough to override the male influence. Also, any hormone containing implant or hormone containing IUD is going to exacerbate the male pattern symptoms, especially weight gain and acne so these options are also not appropriate. If your doctor is not comfortable checking your hormone levels or doesn’t know how to interpret those values once you’ve had them drawn, then contact my office and I will help you.

In addition, you may be having undue stress (who doesn’t have stress these days) with anxiety; stress can also trick your body and uterus, causing nuisance bleeding that has no rhyme or reason; taking Vitamin B Complex with METHYL Folate and METHYL B12 is key to helping manage your stress.

Dr. Victoria J. Mondloch

Office: 262-524-9116