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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]
With all extended-cycle COCPs, breakthrough bleeding is the most common side effect, although it tends to decrease over time. [18] In a 12-month study of a continuous COCP regimen, 59% of women experienced no bleeding in months six through twelve and 79% of women experienced no bleeding in month twelve. [ 19 ]
Hormonal therapies to reduce or stop menstrual bleeding have long been used to manage a number of gynecologic conditions including menstrual cramps (dysmenorrhea), heavy menstrual bleeding, irregular or other abnormal uterine bleeding, menstrual-related mood changes (premenstrual syndrome or premenstrual dysphoric disorder), and pelvic pain due to endometriosis or uterine fibroids.
The most common side-effects of combined hormonal contraceptives include headache, nausea, breast tenderness, and breakthrough bleeding. Vaginal ring use can include additional side-effects including vaginal irritation and vaginal discharge. Contraceptive skin patch use can also include a side-effect of skin irritation around the patch site. [39]
While unpredictable breakthrough bleeding is a possible side effect for all hormonal contraceptives, it is more common with progestogen-only formulations. [16] Most regimens of COCPs, NuvaRing, and the contraceptive patch incorporate a placebo or break week that causes regular withdrawal bleeding.
DMPA, under brand names such as Depo-Provera and Depo-SubQ Provera 104, is used in hormonal birth control as a long-lasting progestogen-only injectable contraceptive to prevent pregnancy in women. [ 38 ] [ 39 ] It is given by intramuscular or subcutaneous injection and forms a long-lasting depot , from which it is slowly released over a period ...
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