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Managing breakthrough bleeding
Breakthrough bleeding is a common condition that almost every woman will experience at some point in her life; however, if you experience abnormal bleeding, you should watch out if it indicates other diseases or problems related to your reproductive system.

Do I need to see a doctor?

Occasional and light spotting is normal, but you should see a doctor if this problem is bothering you, or if you have any of the following symptoms1:

  • Unusual spotting or vaginal bleeding
  • Breakthrough bleeding that lasts more than 3 days
  • Excessive vaginal bleeding
  • Heavy bleeding after sex
  • Light spotting that continues for three menstrual cycles
  • Postmenopausal vaginal bleeding
  • Vaginal bleeding that occurs more frequently than every 3 weeks
Having a doctor to examine you, even when you are having heavy breakthrough bleeding, is the best way to diagnose your condition. So, do not hesitate to talk to your doctor.

What can I do if I experienced breakthrough bleeding due to oral contraceptives?

You should consult your doctor if your breakthrough bleeding is resulted by oral contraceptives and does not let up after a few months.2 Your doctor may also do some diagnostic tests to rule out other potential causes of your bleeding. If you wish to continue using the oral contraceptives, your doctor may switch you to other types of pill.3

Can breakthrough bleeding be prevented?

Breakthrough bleeding can be prevented or its risk can be reduced. Check out the following prevention methods1:

Take contraceptive pills on time
Do not skip pills and take your pill at around the same time every day if possible.

Limit the intake of aspirin
Aspirin is a medication that is often used to treat pain, fever and inflammation. It can thin your blood and worsen your breakthrough bleeding.

Consider other contraceptive methods
The use of intrauterine device (IUD) is commonly associated with breakthrough bleeding that is not harmful. However, if it caused any inconvenience to you, you may want to consider changing to other family planning methods. Ask your doctor about this.

Manage stress
Relieve yourself from stress after a busy day by doing some relaxation activities such as yoga, meditation, deep breathing, aerobic exercise, visualization, and listening to soothing music. You can also talk to your friends and family if necessary.

Monitor your menstrual cycle with a menstrual diary
Keep track on the following with your menstrual diary, which may be useful for your doctor during diagnosis:

  • Dates of your menstrual periods.
  • Any spotting before your period or during your cycle (duration and degree of bleeding, and whether the bleeding is associated with vaginal discharge).


  1. Everyday Health. Spotting Between Periods: A Cause for Concern? Available at: http://www.everydayhealth.com/pms/spottingbetweenperiods.aspx. Accessed 15 December, 2015.
  2. Mayo Clinic. Birth Control. Available at: http://www.mayoclinic.org/healthy-lifestyle/birth-control/expert-answers/seasonale-side-effects/faq-20058109 . Accessed 15 December, 2015.
  3. Lohr PA, Creinin MD. J Fam Practice 2006;55:872–880.