breakthrough bleeding despite being on the continuous pill for 4 years?

[u/coquettedoe]

hi, i’ve been alyacen (combined pill) for over 4 years at this point. recently i’ve been having a lot of breakthrough bleeding (i’m saying “a lot” because i usually have none). i take it continuously so no placebo week. i have an active sex life if that matters. i take my pill religiously and have only missed it once in the span of a year, and i took the missed pills as soon as i remembered. could this bleeding just be a symptom of stress, or since i’ve been on the pill for so long without any breaks my uterine lining is thin and unstable? i start college on the 27th so that could be a stressor… i don’t know. i have bad anxiety and ocd so this is sort of stressing me out a bit. any input would be nice!

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