What is the difference between withdrawal bleeding and menstruation?

Perhaps heavy and painful periods were one of the reasons for you to start using hormonal contraception , and although you take the pills regularly and the period pain has subsided, you still… bleed after taking each blister. Why is this happening? What exactly is withdrawal bleeding? 

To understand this properly, let's first take a look at ovulation!

Missing period while on birth control pills – causes

It's simple - no ovulation. We've already written about ovulation in detail here: "Her Highness Ovulation ".

Just a quick reminder from me: the menstrual cycle repeats itself at different intervals – usually from 21 to 35 days, and on average every 28. In each cycle, the process of ovulation occurs – then, usually between the 13th and 16th day, the ovarian follicle (the so-called Graafian follicle) matures and bursts. And what then? An egg! ;)

Because it is this that is released from the follicle and sets off on its journey to the fallopian tube. There, the egg can be fertilized by contact with sperm… and all this has a chance to happen every month – unless you take birth control pills regularly .

In addition to changing the viscosity of the cervical mucus , birth control pills are designed to block ovulation – they lower the level of hormones, stopping the standard course of the ovulation process. Thanks to the action of the pills, taken according to the recommendations (!), you do not have ovulation and fertile days. And since ovulation does not occur, menstruation does not occur either. The absence of a period on the pill is a normal and desirable phenomenon.

We also encourage you to read the article " Intimate gel and contraceptive pills - do they interfere with each other? ".

Where does bleeding come from while taking birth control pills?

Bleeding while taking birth control pills is called withdrawal bleeding, which is not a period. However, it may resemble a period in color and frequency. The best thing is that, compared to a period, withdrawal bleeding should not be accompanied by almost any pain. This means that you can forget about the hot water bottle and painkillers for a while!

When does withdrawal bleeding occur?

Withdrawal bleeding occurs after taking all active hormonal pills – during the break between blisters or while taking placebo pills.

If you are using the classic two-component pill (i.e. with synthetic estrogen and progestogen), after taking 21 pills, you either take a week break or take 7 placebo pills. The situation is similar when using the 24 + 4 variant (only the length of the break or the time of taking the placebo changes).

After taking all the active tablets in the blister, regardless of their number, withdrawal bleeding occurs . This is quite normal and is a result of the decrease in hormone levels in the body. Usually, the longer you take the pills, the more regular the withdrawal bleeding becomes.

What about people who take the pill on a continuous regimen?

Some of them will tolerate this schedule well. However, the body can react differently to the lack of breaks - so some people will experience light spotting for a few days each month . From a medical perspective, this situation does not pose a health risk, but it can be a source of discomfort.

How long does withdrawal bleeding last?

You are probably wondering how long you may experience withdrawal bleeding and whether it will occur after every blister of active pills you take.

As a rule, withdrawal bleeding lasts about 3 or 4 days and occurs during each break between birth control pills. However, at first (for about the first 3 pill packs), withdrawal bleeding may be irregular. Don't worry about this - just give your body time to get used to the new situation, which is hormonal contraception.

What does withdrawal bleeding look like?

It can take many forms. Sometimes it appears as just a light spotting (and thanks to this you can switch from pads , a cup ortampons to thin pads ). A scanty withdrawal bleeding is perfectly fine – it shows that the use of contraceptive pills is proceeding properly. A very long and heavy withdrawal bleeding, occurring after several (from about 4 to 6) months of regular pill taking, may be a cause for concern.

Consult your gynecologist about this condition. This will help you rule out any diseases of the reproductive system and check whether the large blood loss has not led to anemia.

Withdrawal bleeding did not occur. Now what?

What to do if withdrawal bleeding has not occurred at all? Don't panic, this sometimes happens. The contraceptive pills you are taking affect the growth of the mucous membrane. It may turn out that withdrawal bleeding did not occur because there was too little mucous membrane to shed. Also remember that if you are using single-ingredient contraceptive pills (so-called "mini" pills, containing only progestogen), withdrawal bleeding will practically not occur at all.

Another possibility for why withdrawal bleeding did not occur is that the hormone level is too high , which persists during the break in taking active pills. Another option is a possible problem with the effectiveness of contraception (for example, if you happened to miss one of the pills, vomited or had diarrhea). However, before you start stressing yourself out, make an appointment with a gynecologist.

Remember that pills taken as directed are one of the most effective methods of contraception!

You can read about all contraceptive methods in our articlehere .

When does my period return after stopping birth control pills?

Most often this happens in the next cycle, occasionally only after a few months.

When you take birth control pills, your body gets used to taking in certain amounts of hormones. Once you stop taking the pill, it will take some time for your biological processes to return to their former state.

After taking the last pack of pills, you will first have a classic withdrawal bleed. Your period will most likely come back in the next cycle, but sometimes it won't come that quickly.

Occasionally, the absence of a period after stopping the pill will last for up to 3 months, and in even rarer cases – 6 months. Along with menstruation, characteristic menstrual symptoms will also return – and this is the easiest way to know that “this is it”. The period will also be heavier than the withdrawal bleeding. So have a pack of your favorite tampons, pads or menstrual cup at the ready ;)

And if your period doesn't return within a maximum of 6 months, be sure to consult your doctor!

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