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What Cause Spotting When On Birth Control Pills?
Question: hi i still continue to spot when i am on birth control. right now i am on cilest. I have tried 3 different kinds of birth control but everytime i start to spot. in january i was checked again with pap smear negative and also hpv negative. Could i still have cell changes and that be why I bleed. I furthermore have severe pain around my periods which include diarrhea etc. my doctor has suspected endometriosis. I sometimes have some pain around my navel which comes along with the bleeding. i am now 8 days in my pill package. Do you think i need to stop taking the pills or could all this be related to endometriosis?i recently had an ultrasound and pelvic exam but doctors didnt find anything
Brief Answer:
various conditions should be ruled out
Detailed Answer:
Hi XXXX, I have gone through your question and understand your concerns. Irregular spotting even on oral contraceptive pills can be due to hormonal disturbances or local lesions in cervix or vagina including cervical cancer.Endometriotic lesions in the cervix or vagina can also cause spotting.
However, if your pap smear and HPV are negative, chances of cell changes in the the cervix are minimal.
Spotting when started on oral contraceptives can also be due to changes in the uterine endometrial lining, as the oral contraceptive pills have effect on the uterine endometrium.
Severe pain around the periods, with pain around the navel can be due to endometriosis. Pelvic examination generally rules out endometriosis, however laparoscopy can diagnose it completely.
I would suggest you to stop the birth control pills and get a colposcopy to definitely rule out cervical cancer, an endometrial biopsy to rule out any endometrial hyperplasia or carcinoma, as both of these are important causes of intermenstrual spotting.
If these are normal, then you can go for laparoscopic examination to diagnose endometriosis.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma
various conditions should be ruled out
Detailed Answer:
Hi XXXX, I have gone through your question and understand your concerns. Irregular spotting even on oral contraceptive pills can be due to hormonal disturbances or local lesions in cervix or vagina including cervical cancer.Endometriotic lesions in the cervix or vagina can also cause spotting.
However, if your pap smear and HPV are negative, chances of cell changes in the the cervix are minimal.
Spotting when started on oral contraceptives can also be due to changes in the uterine endometrial lining, as the oral contraceptive pills have effect on the uterine endometrium.
Severe pain around the periods, with pain around the navel can be due to endometriosis. Pelvic examination generally rules out endometriosis, however laparoscopy can diagnose it completely.
I would suggest you to stop the birth control pills and get a colposcopy to definitely rule out cervical cancer, an endometrial biopsy to rule out any endometrial hyperplasia or carcinoma, as both of these are important causes of intermenstrual spotting.
If these are normal, then you can go for laparoscopic examination to diagnose endometriosis.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
okay should i stop the pills now or wait this package out. my doctor ordered an mri scan of lower and upper abdomen to see if i have endometriosis . but do you still think i need the other tests too?
Brief Answer:
stop taking the pills
Detailed Answer:
Hi XXXX, thanks for responding. Oral contraceptives were and are still being used in some places for the treatment of endometriosis. These usually do not aggravate endometriosis, rather they alleviate its symptoms. So it is highly unlikely that endometriosis is the cause of the spotting you are having on oral contraceptive pills.
MRI is not the definitive modality to diagnose endometriosis, rather laparoscopy is decisive. However, MRI gives a clue to diagnosis.
In my opinion, you should stop taking the pills and get all investigations done to get a definitive diagnosis and get further treatment accordingly.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma
stop taking the pills
Detailed Answer:
Hi XXXX, thanks for responding. Oral contraceptives were and are still being used in some places for the treatment of endometriosis. These usually do not aggravate endometriosis, rather they alleviate its symptoms. So it is highly unlikely that endometriosis is the cause of the spotting you are having on oral contraceptive pills.
MRI is not the definitive modality to diagnose endometriosis, rather laparoscopy is decisive. However, MRI gives a clue to diagnosis.
In my opinion, you should stop taking the pills and get all investigations done to get a definitive diagnosis and get further treatment accordingly.
Hope you found the answer helpful. Please do get back for further queries.
Wishing you good health.
Regards,
Dr Deepti Verma
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
Dr. Deepti Verma
OBGYN, Maternal and Fetal Medicine
Practicing since :2009
Answered : 5064 Questions
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