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I have very light bleeding during the placebo week of birth control. Should I take action?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

Dr. Sneha Kannan

Published At May 22, 2021
Reviewed AtSeptember 20, 2023

Patient's Query

Hello doctor,

I have been taking a contraceptive pill (Novelon) for the past five years. I am 36 years female, weighing 150 lbs, my height is 5 feet, mother of two sons (10 and 14 years). I stopped taking pills for six months in the middle due to some skin problems and resumed again three months back. But now, I missed my periods during the first placebo week and very light bleeding (for a day) during the second placebo week. Home pregnancy tests are all negative. I am continuing with my pill (the third pack started seven days back). Is this normal, or should I take any action? Should I stop taking drugs? Please guide me.

Hi,

Welcome to icliniq.com.

I want to know which day of the cycle you started your first pack. When you start your first pack after a gap of six months, you will get the contraceptive benefit right from the word go if you started the first pack on day one of your cycle. There is only one placebo week with nonhormonal tablets when you should get the bleeding. It is not two placebo weeks. But since you had a light one-day bleeding and your home pregnancy tests were negative, you can continue with the pill. This time I expect you to have some bleeding during the placebo pill week. It is not uncommon to have light bleeding that is lesser than usual when you are on an oral contraceptive pill. But suppose you are concerned about the lack of bleeding, you can change the drug or have an IUCD (intrauterine contraceptive device) inserted, or you can also take Depo Provera injections (Medroxyprogesterone acetate) once in three months after consulting a specialist. These are your other options. But for now, you can give Novelon (Desogestrel and Ethinyl Estradiol) a try for one or two months. If you want to change your method of contraception, you should do it only during periods.

I hope this helps you clear your doubts.

Patient's Query

Hello doctor,

Thank you. I started the first pack on the second day of my cycle. After the first pack, I have not got my period bleeding. After the second pack, I had very light bleeding. So, by "second placebo week," I wanted to mean "after the second pack." I started my third pack seven days back. If I see no bleeding after the third pack, do I need to change the pill or can I continue?

Kindly help.

Hello,

Welcome back to icliniq.com.

So actually, you had bleeding late, which is when you were on your hormonal tablets. That explains why you had a very light period of one day only. Let us wait for the first 21 tablets of this pack to finish and see if you get a withdrawal bleed during the placebo week. If you are comfortable with Novelon, you need not discontinue the pill because your withdrawal bleeding is light or sometimes nonexistent. It does not matter as long as you take the pills regularly.

I hope this was helpful for you.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. C. Anuradha Kamalaratnam
Dr. C. Anuradha Kamalaratnam

Obstetrics and Gynecology

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