Birth Control: Your Contraceptive Questions Answered
Medically reviewed by Carmen Fookes, BPharm. Last updated on Feb 10, 2021.
How Long Do You Bleed After Mirena Is Inserted?
Mirena is an interuterine device that contains levonorgestrel, a progestin hormone. Mirena provides contraceptive protection for up to five years.
Mirena works by decreasing the quality and volume of cervical mucus, preventing the migration of sperm through the cervix and uterus. In some women, Mirena may prevent ovulation, but usually only during the first year of use. As well as being an effective contraceptive, Mirena is also approved for the treatment of heavy menstrual bleeding, and to protect the endometrium during estrogen replacement therapy.
Unfortunately, bleeding following Mirena insertion is common. More than 67% of women experience irregular bleeding, and more than 22% experience prolonged heavy bleeding in the first 90 days following Mirena insertion. However, within a year, bleeding significantly diminishes in most women, with 16% reporting no bleeding at all (amenorrhea) and 57% reporting infrequent bleeding.
Even though the unpredictable nature of this bleeding is a nuisance, studies have shown that overall it is much less than a period. Most women who choose to continue with Mirena eventually stop bleeding. But how long this takes varies.
I Took Contraceptive Pills For Only Two Days Before Having Unprotected Sex. Chances Of Pregnancy?
Your chances of pregnancy depend at what point in your menstrual cycle you were at when you started taking the combined oral contraceptive (contains both estrogen and progestin).
If you took the contraceptive from the first day of your period, and continued taking it after having unprotected sex two days later, your chances of being pregnant are virtually nil. Starting the pill within five days of the start of your period protects you immediately.
However, if you started taking the contraceptive pill towards the end of your menstrual cycle (around day 6) or later, then had sex two days later, there is a risk you may have got pregnant, particularly if you are prone to short menstrual cycles of around 21 days (also called being an early ovulator). It takes seven days of continuous pill taking to fully protect you from pregnancy if you start taking the pill midcycle. Once you have been taking the pill for more than three weeks, you should theoretically not get pregnant during your placebo week; however, no pill is 100% effective.
The time it takes to protect against pregnancy for progestin-only pills is much shorter - just two days of continuous pill taking before you are protected. This is because progestin-only pills work on disrupting cervical mucus and sperm mobility.
I Got My Period While On The Active Pills. Is This Normal?
The combined oral contraceptive pill "tricks" your body into thinking it is pregnant. However, some women experience bleeding mid-cycle, even though they may not have missed any active pills or have always taken their pills at the same time each day.
This "break-through" bleeding may be light (often referred to as "spotting"), but in some women it can be heavy, like a period. However, it has nothing to do with your menstrual cycle and tends to be a sign that your body is adjusting to the extra hormones it is receiving through the contraceptive pill. It more commonly occurs within the first few months of starting the oral contraceptive and usually resolves spontaneously. Smokers are especially prone to break-through bleeding.
Break-through bleeding can also occur as a result of taking medications that may interact with the pill, with sexually transmitted infections, during pregnancy, or with some other gynecological illnesses. If the bleeding persists, see your doctor.
How Likely Is It To Get Pregnant While On Nexplanon?
Nexplanon contains etonogestrel, a progestin that releases slowly from the implant over time. Nexplanon is inserted under the skin of your upper arm, and provides continuous contraception for up to three years.
Trials have shown that Nexplanon is over 99% effective, provided the implant is correctly inserted and remains in place. That means that for every 100 women who use Nexplanon, no more than one will become pregnant. However, it is important to note that many trials failed to include women who were overweight, and it is possible that effectiveness may be reduced in these women.
If correctly inserted within five days of a woman's menstrual period, Nexplanon is effective right away. If Nexplanon was inserted at any other time during the menstrual cycle, it can take at least seven days before it is fully effective, and other methods of birth control, such as condoms, will need to be used over this time.
Many women report changes in their menstrual cycle patterns with Nexplanon, such as longer or shorter cycles, or no bleeding at all, and these may be confused with being pregnant.
Is Abdominal Pain Normal While Taking The Pill?
Many women report a dramatic reduction or elimination of period pain once they go on birth control pills. A Cochrane review suggested that this was probably due to the hormones that make up the combined oral contraceptive (OC) pill suppressing ovulation, which in turn reduces the amount of prostaglandins produced by the lining of the uterus. This results in a reduction in blood flow and cramps. However, experts concluded that more research needs to be done.
Conversely, some few women report abdominal cramps soon after starting the combined oral contraceptive. Experts aren't exactly sure why this is, but some research points to estrogen increasing the permeability of the gut, making it prone to a wide range of digestive issues. Studies have shown an increased incidence of Crohn's disease in women taking OCs. Hormonal birth control has also been linked to gallstones, gastroenteritis, irritable bowel syndrome and ulcerative colitis. Nausea is another common side effect of the pill and many women report changes in their bowel movements.
In most women, abdominal cramping is temporary and resolves after a few months of being on the OC. If pain persists, or if worrying symptoms such as blood in the stools or vomiting occur, see your doctor.
I Have A Lot Of Questions About Sex And How To Prevent Pregnancy. Where Can I Go For Help?
The United States still has the highest teenage pregnancy rate in the world. Many teens are ill-informed about what sexual practices actually lead to pregnancy and the best type of prevention against not only pregnancy, but also sexually transmitted infections.
Which is why it is so important to find an accurate, informative, and teen-friendly site. Check out Power to Decide for comprehensive information about birth control options, sex, and relationships. Love is respect also talks about the importance of healthy relationships and mutual respect. Drugs.com also has expertly written information about birth control and sexually transmitted infections.
Finished: Birth Control: Your Contraceptive Questions Answered
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- Safety Considerations for Mirena. 2020 Mirena.com. https://www.mirena-us.com/mirena-side-effects-and-safety
- Eagleson H. Your Odds of Conceiving at Every Point in Your Cycle. Parents.com April 10, 2013 http://www.parents.com/getting-pregnant/trying-to-conceive/ovulation-getting-pregnant/
- What is NEXPLANON (etonogestrel implant)? Nexplanon.com http://www.nexplanon.com/what-is-nexplanon/
- Wong CL, Farquhar C, Roberts H, Proctor M. Oral contraceptive pill for primary dysmenorrhoea. Cochrane Database of Systematic Reviews 2009, Issue 4. Art. No.: CD002120. DOI: 10.1002/14651858.CD002120.pub3.
- Khalili H, Higuchi LM, Ananthakrishnan AN, et al. Oral contraceptives, reproductive factors and risk of inflammatory bowel disease. Gut. 2013;62(8):1153-1159. doi:10.1136/gutjnl-2012-302362.
- State Policies on Sex Education In Schools. Why Is Sexual Education Taught in Schools? 2020 http://www.ncsl.org/research/health/state-policies-on-sex-education-in-schools.aspx