What is withdrawal bleeding? When a woman regularly uses birth control pills, it is not new for her to experience bleeding for several days after the pack runs out. The so-called break week coincides with a temporary break in taking the hormones contained in the drug. During this break, the level of hormones in the body decreases, which leads to bleeding.
Although this is often called menstruation, you should know that it is not actually a true menstrual cycle, but bleeding caused by a lack of hormones - withdrawal bleeding . Even if nothing seems to change for a woman, from a physiological point of view, this phenomenon has important differences.
How do birth control pills “work”?
Combination birth control pills contain synthetic estrogen and progestin , which suppress ovulation and alter the endometrial lining. When a woman takes the pill for 21 days in a row, hormone levels remain constant, preventing ovulation and maintaining a thin endometrium. During the week of withdrawal, hormone levels drop sharply, causing the endometrial mucosa to partially peel off, which results in withdrawal bleeding.
Even with a normal menstrual cycle, menstruation occurs in response to a sharp drop in progesterone levels, but in this case the body realizes that fertilization has not occurred, and therefore it is necessary to begin a natural “cleansing” and preparation for ovulation in the next month. When taking the pills, there is no ovulation and, therefore, the body does not prepare for pregnancy.
How long does withdrawal bleeding last?
The duration of withdrawal bleeding varies from woman to woman, but is usually limited to a few days and tends to shorten further. This occurs due to a decrease in endometrial proliferation under the influence of the tablets.
If withdrawal bleeding does not occur within the usual time frame, it may be worth taking a pregnancy test or seeing a doctor, although pregnancy is unlikely unless there are medication errors. Withdrawal bleeding is often accompanied by less pain and cramping than a natural period, although individual experiences may vary.
Is it possible to have sex during withdrawal bleeding?
When taken correctly, birth control pills prevent unwanted pregnancy, even if you have sex during a break. Thus, there are no medical contraindications to sexual intercourse during withdrawal bleeding, with the exception of a higher risk of infection with sexually transmitted diseases.
Please keep in mind that taking birth control correctly is very important and you should take all necessary precautions to follow your doctor's instructions exactly. If you missed an appointment, then don’t panic or worry. Be vigilant and use other means of contraception. If necessary, contact a gynecologist at Bogolyuby MC for comprehensive recommendations.
Is withdrawal bleeding necessary?
Withdrawal bleeding is usually considered a positive indicator that birth control pills are working properly, but in reality it is simply a form of artificial menstruation. The absence of this bleeding is not necessarily a cause for concern, especially if the pill was taken correctly. Indeed, there are birth control pills whose dosage plan requires continuous use for 3 months, or even subdermal implants that last 3 years (during which there can be no bleeding).
Withdrawal bleeding suggests a predictable cycle that can be psychologically reassuring. For many women, the pill can reduce symptoms associated with natural menstruation, such as pain and heavy bleeding.
