Breakthrough bleeding is unexpected vaginal bleeding or spotting that happens between your regular periods. It usually happens because of changes in your hormones, like when you start or change birth control, are pregnant or take new medicine. But it can sometimes be a sign of a health problem.
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Breakthrough bleeding is light bleeding or spotting between your periods. It happens when you don’t expect it. Most of the time, breakthrough bleeding is an inconvenience and not a sign of a bigger problem.
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Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
It usually happens when your hormone levels change. This can happen when you miss a dose of birth control pills, change to a new form of birth control or transition to menopause. Sometimes, infections or pregnancy cause it.
If you bleed outside of your normal period, keep track of when and how often it happens. Your healthcare provider can help you figure out the cause and suggest how to fix it.
Breakthrough bleeding can last a few hours or a few days. It typically stays very light, but it can be heavier. Unlike a period, which follows a pattern — light, then heavy, then light again — breakthrough bleeding tends to be more random and unpredictable. It doesn’t build up and then taper off.
It’s usually dark brown or light red, like the start of your period. But it can also look more like a regular period — pink or dark red.
The most common cause of breakthrough bleeding is hormonal birth control. This includes pills, IUDs, implants or any other method that uses hormones. You’re more likely to bleed if you miss a dose or switch to a new hormonal birth control. It’s also more common with low-dose or extended cycle birth control pills.
Big changes to your hormones — like going through puberty or menopause — can also cause breakthrough bleeding.
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Other causes could include:
No, breakthrough bleeding doesn't count as a period. But it can make tracking your period harder. If it lasts more than a few months, talk to your provider.
Anyone can have breakthrough bleeding, but you’re most likely to have it if:
Breakthrough bleeding usually isn’t harmful — but it can be frustrating. Your healthcare provider will start by trying to figure out what’s causing the bleeding. They’ll ask questions about the medications you take and if you ever miss/skip doses of your birth control. They may perform a quick pelvic exam.
The exact treatment they recommend depends on the cause. If the bleeding is from hormonal birth control, they may switch you to a new pill or recommend other birth control options. You can use pads or tampons while you wait for your hormones to balance. It can take up to three months for breakthrough bleeding to improve.
If your provider thinks an infection, fibroids or another medical condition may be the cause, they’ll run tests to make sure. Then, they’ll recommend treatment based on what they find (for example, antibiotics for an infection, or treatment for polyps or fibroids). It can still take several days for the bleeding to improve.
It’s usually not a reason to worry. But you should call your provider if:
It can be alarming to bleed between periods — especially when you’re not expecting it or it keeps happening. Most of the time, breakthrough bleeding occurs when your hormone levels change due to factors like birth control, medications, pregnancy or stress. It can sometimes be a sign of a more serious problem, like an infection or miscarriage.
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Contact your healthcare provider if the bleeding happens often, is heavy or is unusual for you. They can figure out the cause and recommend what to do next.
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Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards.
Cleveland Clinic’s health articles are based on evidence-backed information and review by medical professionals to ensure accuracy, reliability and up-to-date clinical standards.
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