midcycle spotting

iVillage Member
Registered: 03-26-2003
midcycle spotting
4
Tue, 10-05-2004 - 1:54pm
I've read the post in the faq section on irregular bleeding but still have questions.

I'm in month 3 of Yasmin. I took a week off after month 1, and then took months 2 and 3 back to back. I've been way stressed (school finals, money and job issues, etc), and was wondering how stress might affect bleeding while on the pill, since stress can affect the normal/non pill cycles. Reading through the faq post, I realize I'm not eating as much/well as before and that can be a factor, as well as being still new to this pill, having taken two packs back to back, was on another low dose pill with break through bleeding before.

I started spotting on day 13 (4 days ago), so I'm not overly worried about length yet, as I had spotted 14 out of 21 days on a different pill. My main concern, is that I'm having low-level cramps, if on a pain scale of 1-10 my usual/non pill cramps are about an 8, these are probably a 2 maybe 3. Is this indicitive of something I should be more concerned about? Should I take the inactive pills this month, instead of waiting until the end of next month like I was wanting to?

I'm trying to eat more, and when the school stress is over next week, it will be alot easier. Is there anything else I should be doing?

thanks

Geo

iVillage Member
Registered: 03-19-2003
Wed, 10-06-2004 - 7:38am
So you're in the middle of which pack? 3, right? So you've had about five weeks of hormones continuously? If that's the case, this is not unusual at all!

Stress typically does not affect your pill cycle. What stress can do (and I don't think I ever experienced this myself, even through all of college and grad school) is delay ovulation in a normal non-pill cycle, and if you delay ovulation, you will also delay the period that follows as a result of ovulation. Your period when you're on the pill is simply a result of the withdrawal of the hormones that are supporting the lining of the uterus. Stress can change how you metabolize the hormones, but most of the time there shouldn't be enough difference for you to see significant changes.

The bleeding and cramping that you're having now is very likely to be a result of taking the two packs back-to-back. As you take active pills, the lining of your uterus grows, and it will keep growing until you stop providing it with estrogen. But if you have more lining than you're providing the progestin to support, it's going to start to degrade and you'll start bleeding. And when you have bleeding, cramping isn't too unusual, this is kind of similar to when you get your pill period except for that there are still hormones going into your system. Make sense? If you're concerned, you can always call your doctor!

If you're bleeding in the middle of the three month cycle you were going for, I wouldn't expect it to stop until you stop taking active pills, though it would be a nice surprise! It's possible that you may not be able to skip periods quite this way with Yasmin, some women can't skip on some pills but can on others because of how each pill is formulated. It's up to you if you want to keep going though, I think some of the women on Seasonale have had their spotting stop if they waited long enough.

Good luck!

Judie
Co-cl for Birth Control
Judie Cl for Birth Control 
iVillage Member
Registered: 03-26-2003
Wed, 10-06-2004 - 12:33pm
Thanks for the reply.

I am on pack 3, 2 days into week 6 of continuous hormones, and the bleeding started at the end of week 5.

I've never had a problem with stress affecting my cycle either through college (the high stress time for me), and more than half of grad school I've been on various BCPs. Having heard enough times that it can happen was curious if it may occur while on the pill.

Out of curiousity, do higher estrogen pills also have more (or a different ratio) of progestin? Your explanation makes sense, but I ask because the last time I had spotting issues, I was switched to a pill with a higher dose of estrogen (I went from Loestrin FE, to Demulin). I will probably see how the bleeding/spotting goes this week, it seems to already be slowing so I may be in luck. I'd rather not have the withdrawal week next week, I have enough other things to worry about with the defense of my thesis! My PCP/gyn had suggested I try the 3 month in a row deal, as I usually have horrid PMS symptoms, and she had even mentioned Seasonale, but Yasmin was the BCP she was pushing when I saw her (the previous time I wanted to get on BCPs it was Alesse. lol).

Anyway, thanks for the info/advice.

:) Geo

iVillage Member
Registered: 03-19-2003
Wed, 10-06-2004 - 9:39pm
Good luck with your defense! In that sense, I don't miss grad school....

To answer your question, the estrogen content often follows the progestin content, rather than the other way around. Demulen has a different progestin than any of the other pills (with the exception of Zovia, its generic), and its progestin is stronger than what's in Loestrin, even though the estrogen dose is higher. We need the estrogen in order to not feel the effects of the larger doses or stronger progestins, too much progestin can make for some pretty uncomfortable symptoms (think menopause)! With the stronger progestins available in the last 15 years, the estrogen and progestin contents have decreased from our moms' pills which may have had 50mcg of estrogen (compared to today's pills which have mostly less than 35mcg). There are a whole bunch of formulations on the market, some of them are more heavy in progestin, some are heavier in estrogen, and there's probably some in between too, it all depends on what works best for each individual.

I think physicians, particularly if they don't have a lot of time to digest all that's new in pharmaceuticals, will tend to favor the marketing of a pill moreso than whether or not it's actually better than another. My gynecologist is really high on Nuvaring and Ovcon 35. My former gyn was high on Triphasil. I think it depends on which pharm rep was in most recently to give him/her the sales pitch and an armload of samples!

Have you been on any pill that hasn't given you heinous PMS? Any that make it better or worse? In my own experience, my periods and PMS were worse when the estrogen content went up. The worst were Triphasil and Ortho Cyclen, not only could I not tolerate the progestins (they're not the same but they're related), but the estrogen content gave me heavier crampier periods than what I was used to on the pill (still not as bad as off-pill). I've been using Nuvaring for almost two years, it's got 15mcg of estrogen, and I have pretty light periods and minimal PMS. But some women have complained of too much bleeding with the ring--we're all different!

But if you are in the market for a new pill....after you defend....maybe we can help you come up with something! Good luck...

Judie
Co-cl for Birth Control
Judie Cl for Birth Control 
iVillage Member
Registered: 03-26-2003
Thu, 10-07-2004 - 12:16pm
>>>Have you been on any pill that hasn't given you heinous PMS? Any that make it better or worse?<<<

Actually, both the Loestrin and Demulen (and technically, I had the generic of each), PMS and normal bleeding was great. I normally have horrid mood swings (bitchiness, cattiness), cramps, backaches, heavy periods and migraines, while on the pill all of the the symptoms were minimal. I don't remember if they got a bit worse on the higher dose or not. I came off of it a year and a half ago, and alot has happened since then so its difficult to recall. I've only had one period on the Yasmin, and it was Ok, we'll see how the next one or two are. I normally have really bad PMS, so it would probably take *alot* for a pill to make it worse. And the way my doc explained, that the pill (or at least I'm assuming the monophasic ones) will even out my hormones and make PMS and period better.

I switched from the Loestrin because of two months where I was spotting greater than 50% of the time, though it was a really light spotting, and no cramps (although as I think back now, I may have taken two packs back to back, so that may have been some cause for it, my doc never mentioned that spotting might be caused by that). I came off the Demulin/Zovia because of high blood pressure (and technically the Loestrin raised my BP some too, but not as bad). If it weren't for the blood pressure issue, I'd probably still be on it. Although, within a few days of not taking it, I felt calmer and less irritable as my blood pressure came down.

So at the time, I wasn't needing the pill for birth control on a regular basis, I was mainly using it to control PMS and the week or so that I was with my BF (a long distance relationship). So we decided not to try any other pills. I saw an endo for a different reason, and she just nodded and said some people have problem extra estrogen. Then when I went back to my original doc, for my annual female exam, birth control was brought up, and we decided to try the Yasmin, which she had just heard a bunch about at some GYN conference.

>>>But if you are in the market for a new pill....after you defend....maybe we can help you come up with something! Good luck... <<<

I realize that it takes some time for my body to get adjusted to the BCP, and since I'm just finishing month 3, and I've already got another pack for month 4, I will probably give it a bit more time. (I may also be moving, and a new/different doc may have completely different ideas and fav. drugs.) But I will definately be around/back, if/when I decide to try a new pill/patch/ring.

:) Geo