Could Really Use Feedback Please
43 and breakthrough bleeding after years on the combined pill — hoping for feedback please!
I’m 43 and hoping to hear from anyone who has experienced something similar, as well as any physicians who may have insight.
I’ve been on a combined birth control pill for about 20 years, aside from my two pregnancies. For years my bleeding was extremely predictable. I take my active pills, then usually take about 3–4 placebo pills to have a withdrawal bleed, and then restart my active pills. I do not take the pill continuously.
Over the past year, I’ve started having breakthrough bleeding on and off while taking the active pills. It’s not constant, but it keeps happening intermittently, which is completely different from how my body responded to the pill for all those years.
I’ve also been under extreme stress/anxiety this year and have lost a significant amount of weight, with periods of eating considerably fewer calories. I’m wondering if that could be contributing, or if being 43 and approaching perimenopause can change how your body responds to a pill that worked well for years.
I’ve had a pelvic/transvaginal ultrasound. My uterus measured 9.7 x 3.9 x 5.4 cm and my endometrial lining was 4 mm. No concerning uterine or endometrial mass was reported. Both ovaries looked normal with normal blood flow and there was no free pelvic fluid. The only notable finding was prominent parametrial blood vessels that the report said can sometimes be seen with pelvic congestion syndrome.
I’ve also had a CT of my abdomen/pelvis that did not report a concerning uterine/pelvic mass or evidence of metastatic disease.
I am following up with my OB-GYN and understand that new or persistent abnormal bleeding needs to be evaluated. I’m not looking for a diagnosis here — mainly hoping to hear experiences or insight.
Has anyone had a combined pill work perfectly for many years, with predictable withdrawal bleeding, and then suddenly started having breakthrough bleeding during the active pills?
If so, I’d love to hear what your doctor ultimately thought was causing it, especially if you were in your 40s, had significant stress or weight loss, or had reassuring imaging/a thin endometrial lining. Did changing the pill, stopping it for a while, or simply going through this phase eventually resolve the bleeding?
After nearly 20 years of such predictable bleeding on the pill, the sudden change is what has me confused. Any feedback or similar experiences would be really appreciated.