Breakthrough bleeding on birth control pills can be caused by:
1) taking the pills incorrectly. There is only 24 hours worth of hormone in each pill. It is therefore very important that the pill be taken at the same time each day (give or take an hour or so). Routinely taking the pills 30+ hours apart is a recipe for bleeding midcycle and/or accidental pregnancy
2) taking antibiotics. There is some evidence that a course of antibiotics may reduce absorbtion of the pill. This can not only lead to bleeding midcycle but also to unintended pregnancy. ALWAYS tell your medical provider if you are taking BCPs and when prescribed antibiotics, use a back up birth control method (such as spermicide and condoms) until the antibiotic course is finished.
3) diarrhea or vomiting for more than 24 hours. Think about it, if you are suffering from either one for any length of time, chances are good that your pill won't be in your body long enough to be completely absorbed.
4) age. Your body changes over time. Your hormonal needs change over time. The birth control pill you start out using will NOT be the only one you will use over the course of your reproductive life.
If you have breakthrough bleeding for two consecutive cycles, call your provider and let them know.
Good luck!
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