Many types of hormonal birth control involve a daily break, during which the person does not receive any of the contraceptives. They can experience bleeding at this time which resembles a period of time. That is known as withdrawal bleeding.
Also, a person may experience withdrawal bleeding if they are discontinuing or switching methods of hormonal birth control.
Keep reading about withdrawal bleeding for more detail, and what to expect from it.
What is withdrawal bleeding?
Many monthly hormonal birth control courses include taking the drug for 3 weeks, or 21 days, and then having none for 1 week.
A individual usually experiences withdrawal bleeding during that break.
The bleeding can imitate the menstruation that would take place if the individual did not use birth control.
A individual is also likely to experience withdrawal bleeding if they quit using hormonal birth control, or turn from one form to another. After discontinuing the medication it can take several months for a person to become normal again.
How long does it last?
The duration of withdrawal bleeding varies from person to person.
If a person takes the medication as prescribed, though, the bleeding will last only for a few days.
If withdrawal bleeding does not occur within 3 weeks of planning, then taking a pregnancy test or consulting a doctor might be a good idea.
Withdrawal bleeding vs. periods
Withdrawal bleeding, like a cycle, occurs when the hormone levels drop.
In both cases the hormone loss causes the mucus and uterine lining to shed and escape through the vagina.
Withdrawal bleeding is usually lighter and shorter than a duration. It is because the synthetic hormones in the contraceptive greatly stop the uterine lining from building up during the menstrual cycle.
Birth control types that cause it
Withdrawal bleeding occurs when a person uses a form of hormonal birth control which includes scheduled breaks during which no medication is given.
The bleeding is the reaction of the body to falling hormone levels, due to the drug split.
Withdrawal bleeding can occur on the following schedules, depending on the course of the drug, according to the American College of Obstetricians and Gynecologists:
- 21-day pill pack: A person takes a pill at the same time every day for 21 days, then takes no pill for 7 days, during which the bleeding may occur.
- 28-day pill pack: A person takes an “active” pill at the same time every day — these pills contain estrogen and progestin, and one pack may have 21 or 24 of them. The bleeding may occur when the person then takes the remaining “inactive” pills.
- 90-day pill pack: A person takes an active pill at the same time each day for 84 days, and bleeding may occur when the person then takes the inactive remaining pills.
A person can put the patch on his or her arms, belly, buttocks, or upper arm. The patch also causes withdrawal bleeding. It functions as follows:
- The person places a patch on their skin and replaces it every week for 3 weeks.
- They remove the patch for the fourth week, when they can expect to have withdrawal bleeding.
- After the fourth week, the person puts a new patch on, and the cycle repeats.
The vaginal ring
Another type of hormonal birth control that makes withdrawal bleeding is the vaginal ring. The use of a vaginal ring will involve:
- folding the ring and inserting it into the vagina
- leaving the ring in place for 3 weeks
- removing the ring at the start of the fourth week, when withdrawal bleeding may occur
- replacing the ring at the end of the fourth week
Is it necessary?
Withdrawal bleeding does not carry any significant health benefits or complications, so it is not medically required.
Rather, it owes its roots to the confidence of one of the birth control pill’s key founders, Dr John Rock.
Dr. Rock devoted himself to the Roman Catholic Church and to creating a functional method of birth control, at a period when the church rejected other contraceptives, according to researchers at New York University.
Dr. Rock argued that because the pill mirrored the menstrual cycle, the church would find it a form of rhythm that is medically regulated.
This process was also repeated by other hormonal birth control methods to achieve public acceptance.
Monthly withdrawal bleeding helps convince some people that they are not pregnant. If a person is not supposed to have withdrawal bleeding, this can suggest pregnancy due to a contraceptive failure.
Since withdrawal bleeding is not strictly required on a monthly basis, certain forms of birth control pills give less regular bleeding episodes, such as once every 3 months.
Sex during withdrawal bleeding
An individual may have sex during withdrawal bleeding safely. The bleeding is medication consequence, not a sign of any health issue.
Hormonal birth control continues to prevent pregnancy, even during a scheduled break from the drug, as long as the person has taken it correctly.
If a person has missed pills or has not taken the drug as prescribed, then it is a good idea to use another type of birth control if they are sexually active during bleeding withdrawal.
Withdrawal bleeding is an inevitable result of certain types of hormonal birth control.
During the course of the drug, the hormone levels of the person fall during scheduled breaks, and they suffer bleeding. Also, it is shorter and lighter than would be their normal time.
For the bleeding, there is no medical need. Many individuals who do not want to undergo monthly bleeding are opting for other hormonal birth control types.
When considering a contraceptive it is a good idea to explore the varied selection of choices with a doctor.
Things to know about natural birth control methods
People who can not or do not want to use hormonal birth control to avoid conception can utilize natural birth control. There are a variety of natural birth control options available, but some are less effective than hormonal contraception.
Birth control, often known as contraception, refers to a variety of procedures, medications, and technologies used to prevent undesired pregnancy. People looking for birth control have a range of options.
Barrier contraception prevents sperm from reaching the female egg, preventing conception. Hormonal birth control works by preventing the generation of hormones that can lead to pregnancy.
Barrier contraception can be used by someone who employs natural birth control methods like tracking ovulation and taking basal temperature measurements.
The various natural birth control methods are discussed in this page, as well as how they operate and how effective they are.
Natural birth control, often known as fertility awareness, is a way of preventing conception that does not include the use of devices or hormone modification. To anticipate ovulation, people track things like menstruation, cervical mucus, and basal temperature.
The ovary releases an egg during ovulation, which is a hormone-driven process. The person menstruates if the sperm does not fertilize the egg or if pregnancy does not occur.
The fertile window for a woman begins 5 days before ovulation. People who use contraception of any kind should be aware that sperm can survive for 2–5 days in the female reproductive tract.
A person may abstain from sex or use barrier contraception, such as a condom, throughout the ovulation period or reproductive window. Barrier birth control is hormone-free and can help prevent unintended pregnancies during a woman’s most fertile period.
People can use a calendar or an online calculator to track their ovulation cycles, such as the ovulation calculator from the Office on Women’s Health.
People who use fertility awareness approaches, on the other hand, may have a higher risk of unintended pregnancy. According to the Centers for Disease Control and Prevention (CDC), traditional fertility awareness approaches have a 2–23% failure rate. This indicates that up to 23 out of every 100 people who use this approach become pregnant each year.
Advantages and disadvantages
Before deciding to utilize natural birth control techniques, it’s a good idea to weigh the benefits and drawbacks.
Before deciding to utilize natural birth control techniques, it’s a good idea to consider the advantages and disadvantages.
- The majority of natural birth control options are free.
- Devices that calculate ovulation windows are available for purchase.
- Natural birth control has no effect on the amount of hormones produced by the body.
- Birth control devices and prescriptions do not require a doctor’s appointment.
- Natural birth control does not cause the same adverse effects as hormonal birth control, such as headaches and nausea.
- Natural birth control might have a failure rate of up to 23%.
- This method’s efficacy is contingent on a person’s willingness and capacity to precisely document their menstrual cycles in order to determine an expected ovulation window.
- People who have irregular or missing periods may find it difficult to track their fertility and may need to adopt a different method of contraception.
- During their ovulation window, people will have to either avoid vaginal sex or utilize another kind of birth control.
- Sexually transmitted infections (STIs) are not protected by natural birth control.
A person can pick from a variety of natural birth control methods. In addition, some businesses may market goods that help people track their fertility.
However, according to the CDC, traditional natural birth control methods are only 77 percent effective at preventing unintended pregnancy. To improve the effectiveness of this kind of contraception, people may want to consider utilizing supplementary birth control methods, such as condoms.
Basal body temperature method
This method needs a person to take their temperature every day when they first wake up with a basal thermometer. People should check that an oral or digital thermometer measures in tenths of a degree Fahrenheit (°F) when measuring basal body temperature.
Ovulation is marked by a prolonged temperature increase of roughly 0.5°F. Although a person with a longer or shorter cycle may experience the temperature spike on different days, ovulation normally occurs around day 14 of a 28-day period.
To reduce the risk of an unintended pregnancy, people should use another type of contraception or refrain from vaginal sex during ovulation.
Apart from ovulation, there are other things that might affect a person’s basal body temperature, including:
- jet lag
- drinking alcohol
People can also buy ovulation tracking and charting kits from firms that sell them. Natural Cycles, for example, offers a fertility tracking smart app that allows people to enter data such as basal body temperature. People can also purchase a basal thermometer from the company to get more precise data.
Ovulation prediction kits
These tests look for the presence of luteinizing hormone (LH) in the urine to see if a woman is ovulating.
To determine when a person is most likely ovulating, most ovulation prediction kits detect an LH surge. Others check estrogen levels, which rise right before ovulation.
Cervical mucus method
To determine ovulation, this approach evaluates the volume and quality of cervical mucus.
Cervical mucus can be checked in a variety of methods. Before urinating, wipe the vaginal area with white toilet paper and observe the color and texture of the discharge. Another option is to check the color and texture of the discharge in your underwear or by inserting clean fingers into the vaginal canal.
The chart below lists the many sorts of discharges that a person can expect throughout the month.
|During menstruation||disguised by blood flow||not applicable||less likely to be more fertile|
|Directly after menstruation||no mucus||no mucus||may be fertile, depending on cycle length|
|Before ovulation||yellow, white, or cloudy||sticky or tacky||may be more fertile|
|Right before and during ovulation||clear or looks like egg whites||slippery and stretchy||most likely to be fertile|
|After ovulation||no mucus, or cloudy mucus||none, or sticky||less likely to be fertile|
Rhythmic technique or calendar
This method involves calculating the most fertile times of the month by charting the menstrual cycle. A calendar or menstrual cycle app, such as Flo, can be used to automatically estimate ovulation after entering menstruation data.
To determine a person’s ovulation window, Planned Parenthood suggests using the following formula:
- Find the shortest tracked cycle.
- Subtract 18 days from the total number of days in that cycle.
- Use this number to count from the start – including day 1 – of the current cycle and mark that day. This is the start of a person’s ovulation window.
To have a better knowledge of when they ovulate, people should track at least 3–6 cycles. This strategy is less likely to work if a person’s cycles are normally shorter than 27 days.
The withdrawal method, also known as pulling out, is removing the penis from the vaginal opening before ejaculation.
This approach has a 4% failure rate when used perfectly. However, this approach is only 78 percent efficient in most cases. In a year, about one out of every five people will become pregnant using this approach. Because pre-ejaculate, the fluid that comes out of the penis just before ejaculation, contains sperm, this procedure has such a high failure rate.
Breastfeeding or lactation amenorrhea
Breastfeeding people can use this approach to avoid unwanted pregnancies.
This approach is only suited for people who match all three of the following criteria, according to the CDC.
- Those who are not menstruating — amenorrhea.
- Those who are exclusively or almost exclusively breastfeeding.
- Those who have given birth no more than 6 months previously.
According to the CDC, this is a temporary method of birth control. If a person does not fit one of the above conditions, they should use an alternative approach.
Any sexual action that does not include vaginal sex or allowing semen into the vagina is considered outercourse.
Some examples of outercourse are as follows:
- using sex toys
- dry humping or grinding
- mutual masturbation
This approach, however, does not protect against all STIs. An STI can be passed from one person to another through skin-to-skin contact.
Hormonal vs. natural birth control
Individuals may wish to see a healthcare practitioner before deciding on a method of birth control to explore the effectiveness and acceptability of various choices.
Natural birth control, male condoms, and the pill, a prevalent form of hormonal birth control, are all described in the table below.
|Effectiveness||Side effects||STI protection||Availability||Cost|
|Natural birth control||77–98% effective||none||none||widely available||none|
|Male condoms||85–98% effective||none||helps prevent STIs||widely available||around $1 each condom|
|The pill||91–99% effective||• mood swings|
• breast tenderness
|none||widely available||$0–$50 per month|
The following are some frequently asked questions concerning natural birth control.
Who should consider about nonhormonal, natural birth control?
Natural birth control is an option for anyone who wants to avoid an unintended pregnancy without utilizing a hormonal type of contraception.
However, a person may desire to speak with a healthcare expert about the various types of contraception available to ensure that they are selecting the best option for them.
What are the most effective natural birth control methods?
According to the CDC, all natural birth control methods, also known as fertility awareness methods, are successful in 77–98% of cases.
If a person wishes to make natural birth control more effective, they should consider using an alternative kind of contraception, such as male or female condoms.
What can I use instead of birth control?
If a person does not want to get pregnant and does not want to take birth control, they should avoid sexual behavior that involves vaginal sex or where semen might enter the vagina.
Natural birth control, also known as fertility awareness approaches, reduces the risk of unintended pregnancy by employing techniques such as basal body temperature, the rhythm method, and the withdrawal method. These techniques can assist in predicting a person’s ovulation window, which is the time when a person is most likely to become pregnant following vaginal sex.
Natural birth control, on the other hand, isn’t as effective as most hormonal and barrier techniques. To lower the odds of an unintended pregnancy, a person who employs fertility awareness methods may want to use another nonhormonal type of contraception, such as condoms.
Birth control and the development of breast cancer: What’s the link?
Hormonal contraception can increase a woman’s risk of breast cancer by a small amount. Depending on the type of contraceptive they use, this can vary. The advantages of birth control, on the other hand, frequently outweigh the disadvantages. Hormonal contraception, for example, may avoid unintended pregnancies and can also protect against other cancers.
Hormonal contraception appears to be linked to a small rise in the risk of breast cancer. This could be due to the fact that oral contraceptives use hormones to prevent women from being pregnant, which could overstimulate breast cells and raise the risk of breast cancer.
Other than oral contraception, there are other forms of birth control. Unintended pregnancies can be avoided without increasing the risk of breast cancer.
Hormonal contraception, on the other hand, can have certain health advantages, such as a lower risk of ovarian cysts and other cancers.
The relationship between birth control and breast cancer will be explored in this report. It will also clarify the advantages of hormonal contraception and provide some options to those who are concerned about the risks. It will also provide details on other breast cancer risk factors.
Is birth control linked to the development of breast cancer?
Hormonal contraception can slightly increase a person’s risk of breast cancer, according to a 2017 report.
A total of 1.8 million Danish females aged 15 to 49 took part in the survey. The women had never had cancer or had undergone fertility therapy.
The researchers discovered that women who used hormonal contraceptives had a significantly higher risk of breast cancer than women who did not. This suggested that one out of every 7,690 participants developed breast cancer.
Other factors, such as age, can influence a person’s risk of developing breast cancer, according to the researchers.
The risk of developing breast cancer was lower in participants under the age of 35. Just one out of every 50,000 women who had been using hormonal contraceptives for a year developed breast cancer.
After around 5 years, a person’s risk of breast cancer appears to return to normal if they avoid using hormonal contraceptives.
Females who still use or previously used contemporary hormonal contraceptives had a higher risk of breast cancer than those who had never used hormonal contraceptives.
Longer periods of usage increased the risk, but the actual increase in risk was minimal.
A type of multiphasic pill is the triphasic pill. According to a person’s period, it switches the hormone dose three times. Monophasic tablets, on the other hand, use the same dose of hormones during the cycle.
In a 2010 survey, 116,000 female nurses between the ages of 24 and 43 were followed. The investigation began in 1989. There was a small rise in the risk of breast cancer, according to the report. Those taking the triphasic pill were the ones that were most at risk.
Another 2014 research found evidence of a correlation between the triphasic pill and an increased risk of breast cancer.
While triphasic pills are still available, they have become less common in recent years. If people taking these pills are concerned about their cancer risk, they should see a doctor.
Is it possible for a woman with breast cancer to use birth control?
Breast cancer patients may want to avoid birth control pills or hormonal intrauterine products (IUDs). Since these approaches can influence the growth of tumour cells in people with hormone-sensitive cancers like breast cancer, they are not recommended.
An individual with breast cancer, on the other hand, has a variety of non-hormonal options.
Alternative methods of birth control
If an individual is concerned about the slightly increased risk of breast cancer associated with hormonal birth control, or if they need to avoid it because they have breast cancer, they could consider:
- Barrier methods: One of the many types of barrier methods available may be a safe alternative to hormonal contraception, such as: condoms, diaphragm, spermicide
- Non-hormonal IUDs: A non-hormonal IUD will prevent pregnancy while also lowering the risk of breast cancer.
- Permanent birth control surgery: If a person is certain they do not want to have children, they should look into the permanent surgical options available to those seeking alternatives to more temporary birth control methods. A man, for example, may consider a vasectomy.
Why should you use birth control?
The advantages of birth control frequently outweigh the risks, according to medical professionals. In the parts below, we’ll go through some of the possible advantages of birth control in greater depth.
Risks associated with pregnancy may be increased.
When compared to the socioeconomic and health threats that an accidental pregnancy will carry, the increased risk of breast cancer is negligible.
According to the American College of Obstetricians and Gynecologists, the maternal mortality rate in the United States was 26.4 deaths per 100,000 females in 2016.
This mortality rate is more than double the figures in the Danish report for increased breast cancer risk due to hormonal contraceptive use (13 additional cases for every 100,000 participants).
The birth control pill is 99.7% effective when taken according to directions, according to the Centers for Disease Control and Prevention (CDC).
The risk of cancer is lower in general.
Some types of birth control have been shown to reduce the risk of certain cancers in women. For example, a systematic review published in 2013 discovered that oral contraception can reduce a person’s risk of:
As a result, despite the slightly increased breast cancer risk, those who use hormonal contraceptives can have a lower overall cancer risk.
Other health benefits
Oral contraception may have additional health benefits, such as:
- a more consistent menstrual cycle
- Premenstrual syndrome symptoms are lessened.
- a lower chance of ovarian cysts
- endometriosis symptoms are reduced
- perimenopause symptoms are reduced,
- acne symptoms can improve
Breast cancer risk factors
Breast cancer is the second most common cancer in American women, according to the National Cancer Institute.
Breast cancer is caused by a number of factors, including:
- Inherited risks: Risks from family history include mutations in the BRCA1 or BRCA2 genes.
- Older age: Age is the main risk factor for breast cancer. The risk increases with advancing age.
- Personal history of breast cancer and breast cancer treatment: A person may be more at risk of breast cancer if they have ever had:
- invasive breast cancer
- ductal carcinoma in situ
- lobular carcinoma in situ
- benign breast disease
- radiation therapy to the chest or breast
- Menopause medications: A person who is using hormone replacement therapy for the symptoms of menopause may have a slightly higher risk of developing breast cancer.
People may take steps to reduce their risk of cancer by doing things like:
- stopping smoking, if applicable
- maintaining a moderate weight
- exercising regularly, where possible
- following a healthy diet
Hormonal contraceptives have been linked to a significantly increased risk of breast cancer, according to research.
Breast cancer is more likely in people who have other risk factors, such as advanced age, a family history of breast cancer, or a personal history of breast cancer.
Hormonal contraceptives, on the other hand, have certain health advantages, such as a lower risk of ovarian and uterine cancer. Whether or not they use hormonal contraception, young women in good health are at an average risk of breast cancer.
Non-hormonal birth control strategies, such as barrier methods, non-hormonal IUDs, or permanent options, such as surgery, may be used by people at greater risk of breast cancer and others who have breast cancer or have already recovered from it.
- Appendix D: Contraceptive effectiveness. (2014).
- Beaber, E. F., et al. (2014). Recent oral contraceptive use by formulation and breast cancer risk among women 20 to 49 years of age [Abstract].
- Breast cancer prevention (PDQ)–Patient version. (2021).
- Is there a link between birth control and breast cancer? https://www.medicalnewstoday.com/articles/birth-control-and-breast-cancer?
- Do hormonal contraceptives increase breast cancer risk? (2017).
- GBD 2015 Maternal Mortality Collaborators. (2016). Global, regional, and national levels of maternal mortality, 1990–2015: A systematic analysis for the Global Burden of Disease Study 2015 [Abstract].
- Gierisch, J. M., et al. (2013). Oral contraceptive use and risk of breast, cervical, colorectal, and endometrial cancers: A systematic review [Abstract].
- Hormonal contraception and the risk of breast cancer. (2018).
- Hunter, D. J., et al. (2010). Oral contraceptive use and breast cancer: A prospective study of young women [Abstract].
- Mørch, L. S., et al. (2017). Contemporary hormonal contraception and the risk of breast cancer.
- Nathan-Garner, L., et al. (2016) The pill and cancer: Is there a link?
- Pernambuco-Holsten, C. (2018). Birth control and cancer risk: 6 things you should know.
What is melasma?
Melasma is a common condition of pigmentation that causes the appearance of brown or gray patches on the skin, especially on the face.
The most prevalent places in which melasma occurs on the face include:
- the bridge of the nose
- the forehead
- the cheeks
- the upper lip
Melasma can also occur in other areas of the body, especially those that are exposed to a great deal of sunlight. These areas may include:
- the forearms
- the neck
- the shoulders
About 10 percent of all cases of melasma arise in men, according to the American Academy of Dermatology. The risk of contracting melasma is higher for women with darker complexions and who are pregnant.
Doctors do not truly grasp why melasma develops. It may be due to the malfunction of the skin’s melanocytes (color-making cells), causing too much color to be developed.
As a result, as they have more melanocytes than people with lighter skin, people with darker skin tones are more likely to develop melasma.
Potential melasma causes include:
- changes in hormones during pregnancy (chloasma), hormone treatment, or while taking birth control pills
- sun exposure
- If they irritate the skin of a human, such skin care ingredients
There may also be a hereditary aspect of melasma, since it is more common for individuals whose close relatives have undergone melasma to acquire it themselves.
The appearance of discolored patches of skin is the main symptom of melasma. Although it does not trigger any other noticeable signs, the existence of these patches is bothersome for some persons.
The most common area for patches of melasma to appear is the face. Uncommon areas include the upper lips, nose bridge, cheeks, and forehead.
An individual can also have patches on their arms and neck, less frequently.
During a visual examination, dermatologists find most cases of melasma easy to diagnose. However, as melasma can be similar to other skin disorders, at the initial visit, a dermatologist can perform a small biopsy.
For further study in a laboratory, a biopsy involves taking a very small part of the tissue.
A practitioner can also use a system called a Wood’s light to look at the skin more closely.
Melasma does not necessarily need medication.
If hormonal changes have induced melasma, such as those arising during pregnancy or when taking birth control drugs, it can disappear after delivery or until a person stops taking the medication.
Melasma will last for years for other people, or even for the remainder of their lives. An individual should seek medication to help remove or fade the patches if the melasma does not fade with time.
Not all treatments, however, work for all, and even after good treatment, melasma can come back.
Melasma treatment options include:
As the first line of therapy for melasma, doctors also use hydroquinone. As a lotion, cream, or gel, hydroquinone is available.
An individual should add the hydroquinone substance directly to the discolored skin patches.
There is hydroquinone sold over the counter, but stronger creams should also be administered by a doctor. Hydroquinone works by rendering skin patches brighter in colour.
Corticosteroids and tretinoin
It comes as creams , lotions, or gels containing corticosteroids and tretinoin. Both corticosteroids and tretinoin can help lighten the color of the melasma patches.
In certain cases, a dermatologist can choose to administer hydroquinone, corticosteroids, and tretinoin-containing combination creams in one. These are called triple creams.
Additional topical medications
Azelaic acid or Kojic acid can also be administered by a dermatologist in addition to or in lieu of other medicated creams. These acids function to lighten the skin’s dark regions.
If topical medications do not work, a doctor may suggest procedures such as:
- chemical peel
- laser treatment
- light therapy
Any of these options for treatment include side effects or can cause further complications with the skin. It is safer to chat about all the potential dangers with a doctor or dermatologist.
If a person has previously had melasma, they may try to prevent causes by:
- limiting sun exposure
- wearing a hat when outside
- using sunscreen
Melasma causes dark spots, most commonly on the face, to form on the skin. While these changes in the skin are harmless, certain individuals can find them bothersome.
For certain patients, therapy is successful. When hormone levels return to normal, melasma that is due to hormonal changes can also diminish over time.