What Causes Spotting Inspite Of Being On Birth Control Pills?

Posted on Mon, 9 Jun 2014

Question: hi i am 34 and i have a history of cell changes.but last in january my pap smear was normal however i testet positive for hpv.i also had a colposcopy which was normal . due to spotting while on birth control pills (malonetta) on my 5th month i now wonder if this is why i spot. last month my doctor took a new pap smear this also came back negative. I have no pain but now for 3 month in a row spotting and this time it started exactly 5 days in on my new packets of birth control pills. So could this be why i spot and is there any way to prevent it . or is it maybe because of interaction of medication.

Answered by Dr. Shanti Vennam (36 minutes later)

Brief Answer:
Detailed below.

Detailed Answer:
Hello,

Thanks for writing to us.

Though abnormal vaginal discharge can be suspected to be caused by infection, it is also true that birth control pills do cause some amount of menstrual disturbances during the early months. These include frequent periods, heavy or scanty periods, inter-menstrual spotting and so on. They usually settle down as the body gets adjusted to the new hormonal milieu in 3-4 months.

Thus, it remains to be seen what exactly has been causing this spotting. Drug interactions, obesity and general infections are some of the other causes for such inter-menstrual spotting. As local causes like polyps of the cervix and uterus, erosions of the cervix and cervicitis have been excluded, general causes should be explored.

Further management depends on the exact cause. Infection can be treated through medication, while hormonal defects need proper assessment for appropriate supplementation. Management of a healthy weight and regular exercise also go a long way to help in the management of the condition.

Hope your query has been clarified. Please feel free to contact for further clarifications. I will be happy to help.

regards,
Shanti.V.

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

Follow up: Dr. Shanti Vennam (11 minutes later)

i am not overweight i am 178 cm and weighs 60 kg. so what exactly do you think i should do now? change pills or expect this spotting to disappear

Answered by Dr. Shanti Vennam (1 hour later)

Brief Answer:
Detailed below.

Detailed Answer:
Hi,

Thanks for writing back.

As far as the medications you have mentioned, there is apparently no drug interaction and thus, this factor can be excluded. Since you had a recent clean pap smear, cervical causes are also ruled out. Weight is not the problem in your case.

So, finally, it appears that the problem perhaps lies with the pills. As I have already mentioned, it may take a couple of months initially for the hormonal milieu to settle down, but, not more than six months. Once the problem persists beyond, you need expert opinion in person and you may have to choose an alternative method or combination.

So, I would suggest that you take the help of a consultant in person and get a proper evaluation for further management.

Hope I have answered your query. Please contact if you need any more information. I will be glad to help.

regards,
Shanti.V.

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