Q:
I am currently taking Desogen. I have been taking it for almost 6 months now. After experiencing intense migraines during inactive pills the first three months, I was instructed to take active pills for three months followed by a week of inactive. I have been taking active pills six weeks now, but have experienced breakthrough bleeding continuously for the past two weeks. Should I continue to take the active pills for the next six weeks or allow my body to have a period by taking a week of inactive pills. I am concerned about so much bleeding as well as it being a huge inconvenience. I will be on vacation next week and would like to control the bleeding if possible. Thanks for your help!
A:
It is not unusual to experience breakthrough bleeding with continuous hormonal therapy as the low dose of hormone in the pills often does not keep the endometrial lining stable. If it is light bleeding or spotting, then there is no concern about you having lost too much blood but if it is heavy, requiring frequent pad or tampon changes, you may be getting anemic and that is of concern. Stopping your pills now may in fact make the bleeding increase temporarily as you have your withdrawal "bleeding" or period from decreased hormonal levels.
Intense migraine headaches and birth control pills are not a good mix, and hormonal contraceptives are contraindicated in the setting of certain types of migraines due to an increase in stroke risk. You will need to discuss your symptoms directly with your women's health provider to determine the best thing to do in your case. If you are receiving your pills from our clinic, you can reach us during our closed intersession by using the virtual visit form or call 650-7328 and leave a message for me to return your call as I need to review your chart to give you the best information. If you are receiving your pills from another clinic, call them today to ask their advice about what is best to do in your situation.
~The Doc
