Hi, Gianvi is a combination oral contraceptive pill containing ethinyl estradiol and Drospirenone, which are synthetic hormones that prevent ovulation and thicken cervical mucus to prevent sperm from reaching the egg. It is not uncommon for women to experience irregular bleeding or spotting when starting a new hormonal contraceptive, as the body adjusts to the new hormone levels. However, if the irregular bleeding persists for more than a few months or is very heavy, it may be worth discussing with your healthcare provider to ensure there are no underlying issues. Acne can also be a possible side effect of hormonal contraceptives, as they can affect the balance of hormones in the body. This can cause an increase in androgen hormones, which can stimulate the sebaceous glands and lead to acne. It is important to note that no contraceptive method is 100% effective, even when used correctly. The withdrawal method, in particular, is not a reliable method of birth control on its own, as pre-ejaculate fluid can contain sperm. If you are concerned about the possibility of pregnancy, it is recommended to take a pregnancy test or consult with your healthcare provider. If you are experiencing significant discomfort or side effects from Gianvi, it may be worth discussing with your healthcare provider about alternative contraceptive options. They may be able to recommend a different pill or another method of birth control that may better suit your needs. Take care. Hope I have answered your question. Let me know if I can assist you further. Regards, Dr. Priyanka, General & Family Physician