Spotting Between Periods While on Birth Control

Spotting between periods, also known as breakthrough bleeding, can occur when you are using birth control pills. The most likely times you could experience spotting are during the first few months of taking an oral contraceptive and if you miss a dose of your pill. Certain medical conditions can also make breakthrough bleeding more likely.

While some spotting usually isn't cause for alarm, you should pay attention to it and keep track of the frequency and amount of bleeding you have. However, if you think you could be pregnant, if you are having severe pain, or if you are seeing a large amount of blood, it is important that you discuss these issues and concerns with your doctor.


Breakthrough bleeding is any amount of vaginal bleeding that occurs in between your periods. Some women see a tinge of blood once or twice in-between periods, while others may have bleeding for a day or longer.

Sometimes women have accompanying lower abdominal cramps (similar to menstrual cramps) a few days before or during the days when breakthrough bleeding is happening.

If you have breakthrough bleeding while taking birth control pills as prescribed, you may experience it one or two weeks before your period, and it should follow a consistent pattern. Typically, breakthrough bleeding recurs for no longer than a few months after starting a new oral contraceptive, and then it stops.

In some instances, women may have a persistent and/or irregular bleeding pattern, especially when repeatedly skipping birth control pills.


Birth control pills prevent pregnancy because they contain estrogen and progesterone (some contain just progesterone). These hormones inhibit ovulation, change cervical mucus, and make the endometrium inhospitable to implantation.

Adjusting to Oral Contraceptives

As your cycle is adjusting to your oral contraceptive, the changing hormone levels alter the endometrial lining in the uterus. This can cause the timing of your period to change and/or cause breakthrough bleeding.

Skipping Doses

If you skip a dose or more of your birth control pill, your body may detect and respond to the fluctuating hormone levels. This can cause breakthrough bleeding due to premature shedding of some of your uterine lining before your period is due to occur.

Medical Conditions

Birth control pills are commonly prescribed for women with polycystic ovary syndrome (PCOS) to regulate menstrual cycles. And if you have endometriosis, a condition in which tissue similar to the lining of your uterus is found outside of your uterus and throughout the pelvic cavity, your doctor might prescribe a birth control pill to regulate any irregular periods you may be having.

Your doctor might also prescribe birth control pills if you have uterine fibroids, as the hormones in the pills may slow fibroid growth and lessen heavy periods.

While birth control pills are used to regulate the menstrual cycle in some health conditions, you can experience spotting when taking a birth control pill to manage a health issue, even if you take the pill as directed.

If you are in perimenopause, you may be predisposed to spotting, and you can experience breakthrough bleeding when taking birth control pills.

When to See a Doctor

Talk to your doctor if you experience spotting during the first few months of taking a birth control pill. You may need to use another method of birth control, such as a condom, to prevent pregnancy as your body adjusts to your new cycle.

If you have missed a few pills or have been inconsistent with when and how you’ve been taking your pill, you may want to use a backup method of birth control until you start to consistently take your pills and resume a regular cycle again. In general, birth control pills are effective for preventing pregnancy, but missing doses diminishes their effectiveness.

If you experience breakthrough bleeding while taking your birth control pills, continue taking them as prescribed. If you have missed pills, ask your doctor or pharmacist for advice on how to proceed safely.

Your instructions will vary depending on the type of birth control pill you are taking, how many pills you missed, and what point you are in your cycle.

Persistent Bleeding

You may have persistent bleeding while using birth control pills. This can occur when the hormones are not at the right dose for you, when you have a medical issue, or if you aren't able to take your pill every day.

If you continue to experience spotting even after a few months of consistently using birth control pills, your doctor might prescribe you a different type of birth control pill to see if it can regulate your bleeding.

There are other options for women who can't take a pill every day due to a busy schedule, frequent travel, or any other reason. You might be a candidate for injectable hormones, which are scheduled at less frequent intervals than oral contraceptives.

A Word From Verywell

Spotting is not usually problematic, but it can happen for a number of reasons, including perimenopause or health issues like polycystic ovary syndrome (PCOS). If you experience spotting while taking birth control pills, be sure to talk to your doctor. You may need a change in your prescription to ensure that you are getting the intended effects of your birth control pills—whether it is the prevention of pregnancy or management of a medical condition.

Was this page helpful?

Article Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial policy to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. 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

  2. Harvard Health Publishing. Dysfunctional uterine bleeding. March, 2019.

  3. Center for Young Women's Health. Medical uses of the birth control pill. Updated July 19, 2018,

  4. Cho MK. Use of combined oral contraceptives in perimenopausal women. Chonnam Med J. 2018;54(3):153-158. doi:10.4068/cmj.2018.54.3.153

  5. Cleveland Clinic. Birth control: the pill. Reviewed November 4, 2016.

Additional Reading