Table of ContentsView AllTable of ContentsPregnancyOther CausesSpotting vs. PeriodWhen to Seek Care
Table of ContentsView All
View All
Table of Contents
Pregnancy
Other Causes
Spotting vs. Period
When to Seek Care
Spotting while on birth control can happen for many reasons, but it usually happens because your body is adjusting to the hormones. This is common during the first few months of starting or switchingbirth control.Spotting is usually very light and may look light pink to brown. In rare cases, it might mean you’repregnant, especially if you missed pills or didn’t take them on time. Signs of pregnancy while using birth control include sore breasts, feeling really tired, feeling sick, or missing your period.
If you notice spotting, you don’t usually need to stop taking your birth control. It’s a normal side effect that often goes away within three months.But if the bleeding is heavy, lasts a long time, or comes with symptoms like stomach pain or dizziness, you should see a healthcare provider. These could be signs of something more serious, like anectopic pregnancyor infection. Don’t ignore it if the spotting doesn’t improve or if you’re worried something might be wrong.
Verywell / Nusha Ashjaee
Can Spotting Be Due to Pregnancy?
Yes, spotting while on birth control can be a sign of pregnancy, but it’s not common. In the United States, about 4% to 7% of women using birth control pills become pregnant each year.Whilebirth control failurecan cause this, it is more often due to human error, such as missed doses.
It may be implantation bleeding if it is:
In addition to implantation bleeding, othersigns of early pregnancywhile on birth control include:
Spotting can also result from pregnancy-related conditions, such asmiscarriageor ectopic pregnancy. A miscarriage refers to the loss of a pregnancy, while an ectopic pregnancy occurs when a fertilized egg implants outside the uterus. Ectopic pregnancies and most miscarriages typically happen within the first three months of pregnancy.
Undiagnosed ectopic pregnancies are life-threatening, and some miscarriages that cause heavy bleeding can be as well. If you experience vaginal bleeding in addition to pain in the abdomen or pelvis, get immediate medical attention. Other concerning signs include low back pain, dizziness or fainting (due to blood loss), and low blood pressure.
Other Possible Causes
Hormonal birth control pills:Spotting, or breakthrough bleeding, is a common side effect of hormonal birth control pills, during the first few months of use as the body adjusts to the hormones. It is especially common in first-time birth control users and usually resolves within three months.
Other hormonal methods:Breakthrough bleeding is most common with low-dose and ultra-low-dose hormonal birth control pills, implants, andIUDs. However, it can happen with any type of hormonal birth control, including the birth control shot, vaginal rings, and skin patches.
Switching birth control:You may experience spotting after switching to a new birth control method, especially if the change involves moving fromnon-hormonalto hormonal methods, progestin-only pills to combination pills, or other hormonal adjustments. It can take a few months for your body to adapt to the new hormone levels.
Improper birth control use:Missing pills or taking them inconsistently can cause hormone fluctuations and lead to unscheduled bleeding.
Uterine fibroids:These noncancerous growths on the uterus tend to occur during the childbearing years. Uterine fibroids often do not cause symptoms but when symptoms do occur, they can include spotting and longer, heavier periods.
Medications:Certain medications can reduce the effectiveness of hormonal birth control, potentially causing spotting or increasing the risk of pregnancy. These include antibiotics such as tetracycline and amoxicillin, antifungal medications like nystatin, and seizure or migraine treatments such as phenobarbital and carbamazepine.
Herbal supplements:A few herbs and herbal supplements have been linked to breakthrough bleeding. The herbsginsengand gingko have been linked to irregular vaginal bleeding due to the hormone-like effect they can have on female reproductive organs.This effect has also been seen with the herbSt. John’s Wort.
Smoking:Spotting and irregular bleeding occur more frequently in people on birth control who smoke cigarettes compared to those who don’t smoke.The exact reasons for this are not entirely clear, but cigarette smoking is a known risk factor for hormonal imbalances. Smoking can also interfere with the way the body metabolizes hormones in birth control, potentially making the uterine lining more prone to irregular shedding.
Perimenopauseormenopause:Perimenopause is the stage before menopause when hormonal levels begin to level off. Women are about 40 to 50 years old when they go through perimenopause. During this phase, women may experience more breakthrough bleeding while on birth control pills. Perimenopausal women are often prone to irregular cycles and heavy bleeding during this phase, too.
Is My Birth Control Working If I Have Spotting?Spotting is a normal response to birth control and usually means your hormones are adjusting. However, if the bleeding doesn’t resolve within three months, is excessive, or occurs with unusual symptoms, reach out to a healthcare provider for an evaluation.
Is My Birth Control Working If I Have Spotting?
Spotting is a normal response to birth control and usually means your hormones are adjusting. However, if the bleeding doesn’t resolve within three months, is excessive, or occurs with unusual symptoms, reach out to a healthcare provider for an evaluation.
How to Tell Spotting from a Period
Spotting can vary in color, timing, and flow, which may make it hard to distinguish from a period. However, there are key differences that can help you tell them apart:
When birth control pills cause spotting, the bleeding tends to occur one or two weeks before the start of a period. The bleeding usually follows a consistent pattern for several months until the body adjusts to the new hormone levels. Then the bleeding stops.
When to See a Healthcare Provider
Call your healthcare provider if you experience spotting during the first few months of taking a new type of birth control pill. While it’s most likely nothing to worry about, it’s a good idea to let your provider know in case the bleeding persists or new symptoms develop.
You should also call your healthcare provider if you experience spotting that is heavy, persistent, or that worsens several months after starting birth control pills or another birth control method. The dosage could be too high, and a simple adjustment could fix the problem. Or, there may be a co-occurring condition causing the abnormal bleeding.
If you experience bleeding with any of the following symptoms, get immediate medical attention:
The above symptoms can be signs of infection, ectopic pregnancy, or cervical cancer. If you experience them or other unusual symptoms, do not hesitate to call or see a healthcare provider.
If you have missed your period or have other signs of pregnancy, especially if you have missed a pill or taken one later than usual, there’s a risk you are pregnant. The blood could be a sign of implantation.
Should I Stop Taking Birth Control If I’m Spotting?If you recently started or switched birth control and notice light spotting without other symptoms like pain, it’s usually nothing to worry about, and you can keep taking it. However, if the spotting lasts longer than three months or comes with unusual symptoms, you should see a healthcare provider. They may recommend switching methods, but never stop taking birth control without consulting your provider first.
Should I Stop Taking Birth Control If I’m Spotting?
If you recently started or switched birth control and notice light spotting without other symptoms like pain, it’s usually nothing to worry about, and you can keep taking it. However, if the spotting lasts longer than three months or comes with unusual symptoms, you should see a healthcare provider. They may recommend switching methods, but never stop taking birth control without consulting your provider first.
Summary
Spotting, or breakthrough bleeding, is a very common side effect of birth control that usually happens in the first three months after starting or switching birth control pills. Less commonly, spotting can be a sign of pregnancy or another underlying condition, like fibroids, endometriosis, or a sexually transmitted infection.
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20 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American College of Obstetricians and Gynecologists.What you should know about breakthrough bleeding with birth control.UPMC.Early pregnancy symptoms.Archer D, Mansour D, Foidart JM.Bleeding patterns of oral contraceptives with a cyclic dosing regimen: An overview.J Clin Med. 2022 Aug;11(15):4634. doi:10.3390/jcm11154634Teal S, Edelman A.Contraception selection, effectiveness, and adverse effects: A review.JAMA. 2021 Dec;326(24):2507-2518. doi:10.1001/jama.2021.21392Lancaster General Health.Implantation bleeding or your period? How to spot the difference.Mount Sinai.Vaginal bleeding in pregnancy.Nemours Kids Health.Ectopic pregnancy.Greydanus D, Bacopoulou F.Acute pelvic inflammatory disease: a narrative review. PM. 2019 Jul;2(1).University of Rochester Medical Center.Vaginitis.Von Voigtlander Women’s Hospital.Uterine fibroids and abnormal bleeding.Weisberg E, Fraser IS.Contraception and endometriosis: Challenges, efficacy, and therapeutic importance.Open Access J Contracept. 2015;6:105-5. doi:10.2147/OAJC.S56400Johns Hopkins Medicine.Polycystic ovary syndrome (PCOS).University of Colorado.Using medications with birth control.Sirotkin A.Potential effects of gingko (Gingko biloba L.) on female reproduction.Reprod Biol. 2021 Dec;21(4):100568. doi:10.1016/j.repbio.2021.100568McGill Office for Science and Society.Hype, hope, and ginseng.Dhage V, Nagtode N, Kumar D, Bhagat A.A narrative review on the impact of smoking on female fertility.Cureus. 2024 Apr;16(4):e58389. doi:10.7759/cureus.58389Cho MK.Use of combined oral contraceptives in perimenopausal women.Chonnam Medical Journal.2018;54(3):153–158. doi:10.4068/cmj.2018.54.3.153American Cancer Society.Signs and symptoms of cervical cancer.Villavicencio J, Allen RH.Unscheduled bleeding and contraceptive choice: Increasing satisfaction and continuation rates.Open Access J Contracept. 2016;7:43-52. doi:10.2147/OAJC.S85565National Cancer Institute.Cervical cancer symptoms.Additional ReadingAmerican College of Obstetricians and Gynecologists.Polycystic Ovary Syndrome (PCOS).
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American College of Obstetricians and Gynecologists.What you should know about breakthrough bleeding with birth control.UPMC.Early pregnancy symptoms.Archer D, Mansour D, Foidart JM.Bleeding patterns of oral contraceptives with a cyclic dosing regimen: An overview.J Clin Med. 2022 Aug;11(15):4634. doi:10.3390/jcm11154634Teal S, Edelman A.Contraception selection, effectiveness, and adverse effects: A review.JAMA. 2021 Dec;326(24):2507-2518. doi:10.1001/jama.2021.21392Lancaster General Health.Implantation bleeding or your period? How to spot the difference.Mount Sinai.Vaginal bleeding in pregnancy.Nemours Kids Health.Ectopic pregnancy.Greydanus D, Bacopoulou F.Acute pelvic inflammatory disease: a narrative review. PM. 2019 Jul;2(1).University of Rochester Medical Center.Vaginitis.Von Voigtlander Women’s Hospital.Uterine fibroids and abnormal bleeding.Weisberg E, Fraser IS.Contraception and endometriosis: Challenges, efficacy, and therapeutic importance.Open Access J Contracept. 2015;6:105-5. doi:10.2147/OAJC.S56400Johns Hopkins Medicine.Polycystic ovary syndrome (PCOS).University of Colorado.Using medications with birth control.Sirotkin A.Potential effects of gingko (Gingko biloba L.) on female reproduction.Reprod Biol. 2021 Dec;21(4):100568. doi:10.1016/j.repbio.2021.100568McGill Office for Science and Society.Hype, hope, and ginseng.Dhage V, Nagtode N, Kumar D, Bhagat A.A narrative review on the impact of smoking on female fertility.Cureus. 2024 Apr;16(4):e58389. doi:10.7759/cureus.58389Cho MK.Use of combined oral contraceptives in perimenopausal women.Chonnam Medical Journal.2018;54(3):153–158. doi:10.4068/cmj.2018.54.3.153American Cancer Society.Signs and symptoms of cervical cancer.Villavicencio J, Allen RH.Unscheduled bleeding and contraceptive choice: Increasing satisfaction and continuation rates.Open Access J Contracept. 2016;7:43-52. doi:10.2147/OAJC.S85565National Cancer Institute.Cervical cancer symptoms.
American College of Obstetricians and Gynecologists.What you should know about breakthrough bleeding with birth control.
UPMC.Early pregnancy symptoms.
Archer D, Mansour D, Foidart JM.Bleeding patterns of oral contraceptives with a cyclic dosing regimen: An overview.J Clin Med. 2022 Aug;11(15):4634. doi:10.3390/jcm11154634
Teal S, Edelman A.Contraception selection, effectiveness, and adverse effects: A review.JAMA. 2021 Dec;326(24):2507-2518. doi:10.1001/jama.2021.21392
Lancaster General Health.Implantation bleeding or your period? How to spot the difference.
Mount Sinai.Vaginal bleeding in pregnancy.
Nemours Kids Health.Ectopic pregnancy.
Greydanus D, Bacopoulou F.Acute pelvic inflammatory disease: a narrative review. PM. 2019 Jul;2(1).
University of Rochester Medical Center.Vaginitis.
Von Voigtlander Women’s Hospital.Uterine fibroids and abnormal bleeding.
Weisberg E, Fraser IS.Contraception and endometriosis: Challenges, efficacy, and therapeutic importance.Open Access J Contracept. 2015;6:105-5. doi:10.2147/OAJC.S56400
Johns Hopkins Medicine.Polycystic ovary syndrome (PCOS).
University of Colorado.Using medications with birth control.
Sirotkin A.Potential effects of gingko (Gingko biloba L.) on female reproduction.Reprod Biol. 2021 Dec;21(4):100568. doi:10.1016/j.repbio.2021.100568
McGill Office for Science and Society.Hype, hope, and ginseng.
Dhage V, Nagtode N, Kumar D, Bhagat A.A narrative review on the impact of smoking on female fertility.Cureus. 2024 Apr;16(4):e58389. doi:10.7759/cureus.58389
Cho MK.Use of combined oral contraceptives in perimenopausal women.Chonnam Medical Journal.2018;54(3):153–158. doi:10.4068/cmj.2018.54.3.153
American Cancer Society.Signs and symptoms of cervical cancer.
Villavicencio J, Allen RH.Unscheduled bleeding and contraceptive choice: Increasing satisfaction and continuation rates.Open Access J Contracept. 2016;7:43-52. doi:10.2147/OAJC.S85565
National Cancer Institute.Cervical cancer symptoms.
American College of Obstetricians and Gynecologists.Polycystic Ovary Syndrome (PCOS).
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