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What Causes Post Coital Bleading?

Posted on Mon, 23 Jun 2014

Question: Hello, I am experiencing post coital bleading for 2 days now and have missed 3 days of birth control prior so i would like to know if it is just hormonal imbalance and if there is something i should worry about being that this has happened only once before however during different circumstances.

Answered by Dr. Aarti Abraham (14 minutes later)

Brief Answer:
AS BELOW

Detailed Answer:
Hello
Thanks for writing to us with your health concern.
Was there any rough sex involved ?
That could explain the post coital bleed.
If this is a first off incident ( discounting the earlier one that you think was justified ) , I would put it down to spotting following the 3 missed pills.
In case this recurs , you need to have a formal evaluation.
Common causes of post coital bleeding are - cervical or vaginal laceration / tear, cervical erosion, growth on the cervix, polyp, protruding fibroid etc.
THis can be easily ruled out by a complete internal evaluation ( per vaginum and per speculum ) and a pelvic transvaginal ultrasound scan.
A Pap smear too would be in order.
All the best
Please feel free to discuss further.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aarti Abraham (14 minutes later)

if missing the 3 days of the pill shall i continue the same pack or proceed with a new one ? i am currently taking oral_i (levonorgestrel & ethinyloestradiol tablets) . Thank you for the response i also thought it may be due to the pill howver what concerned me is the spotting started sunday night but it is heavier than just a light pink color, feels more like the last few days of a light period , i used tampon but it didnt fully soak through out the night so its not too heavy , is this normal ?

Answered by Dr. Aarti Abraham (3 hours later)

Brief Answer:
AS BELOW

Detailed Answer:
Sometimes spotting might be heavier, cannot really say without looking at it.
What day of the pill pack are you on ?

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aarti Abraham (43 hours later)

day 9

Answered by Dr. Aarti Abraham (2 hours later)

Brief Answer:
AS BELOW

Detailed Answer:
Stopping the pills on day 9 will only lead to more unpredictable spotting and confusion.
Finish this pill pack without missing any more pills if possible.
Do not consider yourself protected though, please use back up.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aarti Abraham (46 minutes later)

thank you , the spotting has stopped and i continued taking the birth control. if continuing the pills when shall i consider myself protected again?

Answered by Dr. Aarti Abraham (47 minutes later)

Brief Answer:
AS BELOW

Detailed Answer:
Unfortunately, not this month, as 3 pills have been missed.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aarti Abraham (27 hours later)

well yes i understand , so approximately the following month ?

Answered by Dr. Aarti Abraham (7 hours later)

Brief Answer:
AS BELOW

Detailed Answer:
Yes if you do not miss any more pills and start a new pack next month, you would be protected next month.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aarti Abraham (2 days later)

How long should i expect irregular bleeding being that i missed those pills and understand it may take some time for my body to be back on track ?

Answered by Dr. Aarti Abraham (16 minutes later)

Brief Answer:
AS BELOW

Detailed Answer:
If you continue taking those pills, the spotting should be fine within a week, I would say.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aarti Abraham (2 hours later)

i want to thank you so much for all your help i just have one last question.

So as advised i continued the pills , i have started a slightly heavier spotting again today (still lighter than a regular period), my period last month was on the 11th or so , so im concerned if this is just more irregular spotting due to the lapse in birth control pills or if my period has possibly shifted, i cannot afford to see a doctor at this time so i am just consulting on what percausions i should take and if this is normal ... or if this may be something to worry about . I have been on this birth control for about 4 months. Just in case i believe i should take a pregnancy test to be on the safe side but again would love your advice to be sure.

thank you again for all your time , i know its lots of questions.

Answered by Dr. Aarti Abraham (1 hour later)

Brief Answer:
AS BELOW

Detailed Answer:
Hello again.
Normally do you bleed without having finished your pill pack?
I think this is the spotting due to the lapse in the pills.
How long have you been spotting now ?
A pregnancy test can be taken to reassure yourself, but it would be reliable only when taken at least 2 weeks after the last episode of unprotected sex.
Precautions - just continue taking the pills back to back.
If the bleeding does not stop, you would have to go for the workup that I had initially outlined.
You can go ahead and consult me as much as you wish, it is a pleasure and honour to be able to be of any help.
You can always access me round the clock by directly writing in to me at -
http://doctor.healthcaremagic.com/doctors/dr-aarti-abraham/64623
Take care.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aarti Abraham (44 minutes later)

i was spotting previously when i first contacted you from sund may 25-29 fairly heavy spotting yet not as heavy as a period. And just started again today .

Answered by Dr. Aarti Abraham (7 hours later)

Brief Answer:
AS BELOW

Detailed Answer:
So it has already been a week.
Another thing you can do is finish the current pill pack and then wait for the spotting to stop.
Do not use pills the next month, and wait for your cycles to stabilize.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aarti Abraham (9 hours later)

well i just checked my calander , the spotting was 25-28 and then everything was fine until yesterday and its currently continuing . If i stop after this pill pack i understand i would not be protected and also i would wait until next period to start again or how would that work?

Answered by Dr. Aarti Abraham (3 hours later)

Brief Answer:
AS BELOW

Detailed Answer:
If you stop after this pill pack, you do not start a new one, till you have a proper next period.
Yes, you would not stay protected in that case.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Aarti Abraham (3 hours later)

okay in your opinion , if the spotting stops before i finish this pill pack should i continue with the usual regimine and start the next pack or regardless stop after this one ?

Answered by Dr. Aarti Abraham (8 hours later)

Brief Answer:
AS BELOW

Detailed Answer:
If the spotting stops before finishing the pill pack, continue with the rest of the pills in this pack, and then start the next pack back to back.

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar