What causes breakthrough spotting while on Estrogen?
This is not of great concern...
Thank you for the question and I am happy to help.
When you are on birth control pills, you are essentially taking control of the uterine lining and keeping it from going through its normal cycle of growing and shedding on its own. Birth control pills lead to progressive thinning of the uterine lining which you might notice as lighter and lighter periods. This is normal and safe and the uterus will return to normal after you are off of the pills.
This also leads to extreme thinning of the uterine lining that leads to breakthrough bleeding. This is actually quite common and certainly more common on the lower dose pills.
You options would be to:
1. Observe and see if this is just a temporary problem that does not occur again
2. Change to a slightly higher dose pill
3. Consider the nuvaring (associated with less breakthrough bleeding)
4. Consider something like the Mirena IUD - would also be associated with less breakthrough bleeding
I hope that this helps!