Withdrawal bleeding: Your complete guide to understanding it

If you’re new to birth control, then you’ve probably not heard much about withdrawal bleeding, in which case, this article is an absolute must-read. And even if you do know what withdrawal bleeding is, it’s always a good idea to get a refresher and understand withdrawal bleeding, its symptoms and why it happens, in detail.
What is withdrawal bleeding?
Simply put, when you take hormonal birth control, you’re required to take a regular break, wherein you don’t use the contraceptive. During this period, you may experience bloody discharge that looks like a period, which is known as withdrawal bleeding. This bleeding may look like your typical period, like the one you used to get when you didn’t use birth control.
Additionally, you would be likely to have withdrawal bleeding if you stop using hormonal birth control or switch birth control from one method to another. If you decide to discontinue the birth control, it may take months for your period to become regular again.
Withdrawal bleeding is caused when there is a drop in the hormone levels in your body, which is similar to the way a regular menstrual period occurs. This drop in hormones triggers the lining of your uterus to release some blood and mucus which comes out through the vagina.
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Withdrawal bleeding: Symptoms and how long does it last
You may be wondering, ‘how long will withdrawal bleeding last?’ Well, much like a period, the length of withdrawal bleeding will differ from person to person. However, if one takes the medication as prescribed, the bleeding should only last a few days.
It is important to note that if you don’t get withdrawal bleeding in the three weeks following its expected date, you must consult a doctor. Taking a pregnancy test is also advised.
Different types of birth control will have varied effects on different people. But when using a patch, ring, or a combined 21-day pack of birth control, withdrawal bleeding typically isn’t the same as a regular menstrual period. It’s normally lighter and shorter with fewer symptoms.
However, while on hormonal birth control many women experience menstruation-like symptoms such as:
- abdominal bloating
- tender breasts
- digestive issues such as constipation or diarrhoea
- fluid retention
- weight gain
- headaches
- mood swings.

Which types of birth control cause withdrawal bleeding to occur?
From the many options of birth control available in the market, only some hormonal birth control treatments can cause withdrawal bleeding.
Here are some common hormonal birth control options:
1. Injections
These injections contain progestin and have to be taken once every three months. When taken as prescribed and continuously, these injections don’t cause withdrawal bleeding. However, you may have irregular bleeding and spotting.
2. Intrauterine devices (IUDs)
These are hormonal IUDs that contain progestin. These last about three to five years and could lead to a light period after insertion or no period at all. Copper IUDs are known to last about 10 years and are hormone-free, so your menstrual cycle will function as usual with periods just like it did before inserting the IUD.
Also note that some women may notice that their menstrual flow has increased a little for the first year after getting the IUD inserted.
3. Hormonal patches
These patches contain oestrogen and progestin and are reapplied every week for three weeks. The fourth week is optional before the cycle repeats. It is normal to experience withdrawal bleeding during the fourth or break week if taken as prescribed.
4. Pills
Hormonal pills are the most common form of birth control. There are several types available in the below combinations:
- A 21-day oestrogen and progestin combined pill
- An oestrogen and progestin combined pill intended. These are primarily meant for extended or continuous use
- Lastly, a minipill with includes only progestin.
When taken as directed, the 21-day pill pack typically causes withdrawal bleeding during the fourth or break week.
The oestrogen and progestin combined pill, meant for continuous use, also have a break week scheduled for a withdrawal bleeding. However, the length of the period is longer between periods with these types of pills.
5. Vaginal rings
You also have 21-day oestrogen and progestin vaginal rings available as birth control. These lead to withdrawal bleeding when you wear it for 21 days and then, as prescribed, remove it for a week.

Withdrawal Bleeding vs Period
When you start your break week of not taking hormonal birth control, it may look like you’re getting your period. However, withdrawal bleeding and regular period isn’t the same.
Usually, when you’re not on birth control, the lining of the uterus thickens throughout the month. This happens because your body is preparing itself for a possible pregnancy. If pregnancy does not occur, this lining will shed along with blood and vaginal discharge vagina, also known as a period.
On the other hand, when you take hormonal birth control, the hormones in the medication prevent the lining of the uterus from thickening in the same way. And, when you don’t take the hormones during the break week, some blood and mucus gets shed through the vagina. This is withdrawal bleeding which is generally lighter and lasts for fewer days.
Withdrawal Bleeding vs. Breakthrough Bleeding
The difference in withdrawal bleeding vs. breakthrough bleeding is all in the timing. Withdrawal bleeding happens during the last week of your hormonal birth control course.
However, sometimes, you may also bleed before the withdrawal bleeding week. This bleeding is called breakthrough bleeding.
Breakthrough bleeding is common when you begin hormonal birth control. This is especially true in the first three months when you begin a new medication.
Breakthrough bleeding also happens when you:
- Miss one or more doses of your birth control pills
- Continue taking your birth control during your break week
- Apply your birth control patch the wrong way
- Don’t properly insert your birth control ring
- Take any medication or supplement that interferes with hormonal birth control.
Takeaway
When you begin taking hormonal birth control, withdrawal bleeding is an expected effect. You don’t need medical assistance for this bleeding. Those who do not wish to experience withdrawal bleeding can look at other hormonal birth control options. It is best to speak with a doctor about the range of options and its possible effects when choosing a contraceptive.
Disclaimer:
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