Breakthrough bleeding ( BTB ) is one of many forms of vaginal bleeding, usually referring to mid-cycle bleeding in combined oral contraceptive users, which is associated with insufficient estrogen. It may also occur with other hormonal contraceptives. Sometimes, breakthrough bits are classified as abnormal and therefore as metrorrhagia, and are sometimes classified as not abnormal .
Video Breakthrough bleeding
Presentations
Bleeding is usually mild, often referred to as "spotting", although some women may experience more severe bleeding.
Many women find that breakthrough bleeding stops after one or two cycles.
Maps Breakthrough bleeding
Mechanism
Bleeding breakthrough is most often caused by a very thick endometrium (the lining of the uterus). This is not a dangerous condition, though periods of unexpected and often unpleasant bleeding. Breakthrough bleeding can also be caused by the hormonal effects of ovulation. Bleeding a breakthrough can also be a symptom of pregnancy.
Breakthrough bleeding is most common when a woman first begins using oral contraceptives, or changes from one particular oral contraceptive to another, although a breakthrough bleed may occur at any time. Smokers are particularly vulnerable to breakthrough bleeding when using oral contraceptives; although many users experience breakthrough bleeding in the first three cycles taking pills, non-smokers tend to see bleeding disappear faster than smokers.
Bleeding possible breakthrough due to hormonal fluctuations. The body is programmed to make certain estrogen levels daily and estrogen (and some additional hormones, such as FSH, LH, and Progesterone) are responsible for regulating the shedding of the endometrium. Therefore, when new hormone levels enter the body through oral contraceptives, the body is given two ways to receive estrogen. This excess estrogen level can cause pre-menstrual bleeding (bleeding through). This should be arranged in a few months.
According to Lange Gynecology and Obstetrics, 8th edition, the most common side effect associated with using OC is breakthrough bleeding. Usually occurs during one or two first cycles and resolves itself spontaneously. Another common problem is amenorrhea. Persistent bleeding through haemorrhage and amenorrhea generally reflects the atrophic, or thin and less developed endometrium.
The combined use of estrogen and progesterone eliminates normal endogenous hormonal cycles and gradually results in the atrophy of the endometrial glands. This is because the dose of estrogen in oral contraceptive pills is much lower than the amount produced naturally by the ovaries. The higher amount produced by the ovaries induces proliferation, but the low level supplied by the pill produces atrophy but is sufficient to inhibit the endogenous secretion of gonadotropin.
The exact incidence chains that lead from the atrophic endometrium to spotting between menstruation are not explained by the text. This condition can be corrected by using a pill with higher estrogen (which will stimulate further proliferation of the endometrium) or a lower progestin content (which will reduce its stability).
Treatment
Breakthrough bleeding that does not heal by itself is a common reason for women to switch to different pill formulations, or switch to non-hormonal family planning methods.
See also
- Vaginal bleeding
- Bleeding withdrawal
References
Source of the article : Wikipedia
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