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The bleeding is usually light, often referred to as "spotting," though a few people may experience heavier bleeding. [citation needed] It is estimated that breakthrough bleeding affects around 25% of combined oral contraceptive pill (COCP) users during the initial 3 to 4 months of use, it then usually resolves on its own. [8] [9]
When a woman takes COCP, the hormones in the pills prevent both ovulation and shedding of the endometrium (menstruation). Traditionally, COCPs are packaged with 21 active (hormone-containing) pills and 7 placebo pills. During the week of placebo pills, withdrawal bleeding occurs and simulates an average 28-day menstrual cycle.
If you see spotting the week before your period typically comes but then don’t get a full-fledged period soon after, you should consider taking a pregnancy test. 3. You have a hormone imbalance.
The role of the placebo pills is two-fold: to allow the user to continue the routine of taking a pill every day and to simulate the average menstrual cycle. By continuing to take a pill every day, users remain in the daily habit even during the week without hormones.
Treatment of postmenopausal women with 2.5 or 5 mg/day MPA in combination with estradiol valerate for two weeks has been found to rapidly increase circulating MPA levels, with steady-state concentrations achieved after three days and peak concentrations occurring 1.5 to 2 hours after ingestion.
Vaginal bleeding generally diminishes gradually over about two weeks after a medical abortion, but in individual cases spotting can last up to 45 days. [44] Emergency surgical or medical interventions for prolonged bleeding may be considered based on how the patient feels and if the bleeding seems to be getting better.
Irregular bleeding and spotting: Many women will experience some type of irregular, unpredictable, prolonged, frequent, or infrequent bleeding. [31] Some women also experience amenorrhea . For some women, prolonged bleeding will decline after the first three months of use.
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