Seasonale side effects: Is breakthrough bleeding a concern?

Seasonale side effects include spotting or bleeding between periods (breakthrough bleeding). Although breakthrough bleeding can occur with any birth control pill, it is more likely to occur with extended-cycle birth control pills — such as Seasonale — than with standard 28-day birth control pills. Although annoying, such breakthrough bleeding usually doesn't indicate a serious underlying problem.

The cause of breakthrough bleeding with an oral contraceptive isn't always clear. It seems to take time for your body to adjust to the hormones when you start taking the medication. In addition, you are more likely to have breakthrough bleeding if you:

• Miss a pill
• Start a new medication — such as certain antibiotics — that may interfere with the pill
• Become ill with vomiting or diarrhea, which may impair absorption of the medication

Unpredictable bleeding with an oral contraceptive should decrease over time. With Seasonale, this can take up to a year.

If you experience breakthrough bleeding with birth control pills, it is important to continue taking the medication as directed. Although unlikely, bleeding may persist until your next scheduled period — which can be a fairly long time with Seasonale. Also, don't be concerned if you do not get your next scheduled period after an episode of breakthrough bleeding.

If breakthrough bleeding with birth control pills persists and becomes heavy or bothersome, contact your doctor to discuss alternative contraception before you stop taking the medication.