Back to Answers

Extended-cycle birth control pills: Is spotting common?

Spotting or bleeding between periods (breakthrough bleeding) can occur with any birth control pill, especially during the first few months of use. However, breakthrough bleeding is more likely with continuous and extended-cycle regimens than with the traditional 28-day schedule. Breakthrough bleeding can also occur when taking normal 28-day birth control pills in a continuous manner.

What causes breakthrough bleeding with oral contraceptives isn’t always clear. It may simply take time for your body to adjust to the hormones in the pill or for your uterus to transition to a thinner lining (endometrium).

You’re more likely to experience breakthrough bleeding if you:

Unpredictable bleeding resulting from the use of continuous or extended-cycle birth control pills usually decreases with time. In the meantime:

If breakthrough bleeding becomes heavy or lasts more than seven days in a row, contact your provider. There may be another possible cause for the bleeding, such as an infection. Depending on the circumstances, your provider may recommend an alternative method of contraception.

© 1998-2024 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved.

We Make Health Possible

As East Central Indiana’s population grows, we’re putting health care where people need it most. Besides Hancock Regional Hospital, ranked as one of the nation’s safest by the Lown Hospital Index, our network includes more than 30 other locations near your home or work.

Learn More about Hancock