What are the reasons for breakthrough bleeding?

Question

Hello doctor,

My last period was on the last days of May, and before that on the last days of April. My ovulation should have started by mid-June, but I experienced a mild spotting today. I am on birth control pills. Saheli (a non-steroidal contraceptive pill). Is the spotting due to pregnancy or due to birth control?

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Let's break this down clearly and accurately.

Key info from you:

Last period: last day of May (previous one: last day of April)

Ovulation (estimated): Around mid-June (assuming a regular 28–30 day cycle)

Today’s symptom: Mild spotting

You are on birth control: Saheli (Centchroman/Ormeloxifene, a non-steroidal contraceptive pill)

Understanding Saheli and spotting

Saheli (Centchroman) is a non-hormonal, weekly oral contraceptive. It works differently from typical hormonal birth control and is generally very effective when taken correctly. However, irregular bleeding or spotting is a common side effect, especially in the first few months of use.

Common reasons for spotting on Saheli:

Breakthrough bleeding due to adjustment of the endometrial lining.
Missed or irregular dosing. If the weekly pill is not taken consistently, the lining may not be stable.
Hormonal shifts still occur to some extent since Saheli is not suppressing ovulation fully
Ovulation-related spotting: Mid-cycle spotting can happen naturally due to hormonal dips during ovulation.

Could it be implantation or pregnancy?

Implantation bleeding typically happens six to ten days after ovulation (so not the same day).
It is usually light, pinkish, or brownish spotting, and lasts one to two days
If you are ovulating now (mid-June), it is too early for spotting from implantation - pregnancy-related spotting would not happen until at least the last week of June.

Bottom line:

Spotting today is most likely due to Saheli, especially if this is within your first six months of use or if you missed a dose.
It could also be ovulation-related spotting, which is harmless.
Pregnancy is unlikely at this point, unless you missed pills and had unprotected sex during your fertile window (around the second week of June).

I advise you to do the following:

Continue your Saheli doses as scheduled.
Track the spotting: If it gets heavier, prolonged, or is accompanied by pain, consult your gynecologist.
If you are worried about pregnancy, wait until 14–16 days after the suspected ovulation (around the last week of the month) and do a urine pregnancy test.

I hope this information helps you.

Feel free to ask further queries.

Thank you.