Birth Control Spotting

Patient : I am on Alesse birth control since April 2014. I been taking birth control continuously 3 packs than placebo pills than 3 packs than placebo pills etc. My question is why am I spotting. I think I am spotting when I am suppose to have my period, I know when I am suppose to have my period my breasts get tender. Isn't spotting suppose to stop within 3 months and can I get pregnant? 2nd question. When taking placebo pills they say you cant get pregnant but when you miss a pill you could get pregnant. How is that possible.?
Doctor :   Birth control pills such as the one you are taking are designed to be taken for a duration of 21 or 28 days (21 active p ills + 7 placebo pills). These pill packs are not recommended for continuous use as they have neither been designed nor tested for the same. There are various continuous pill regimens that are available in the market that you could choose from. I would suggest that you speak to your GP or OBGYN or contraceptive nurse regarding the same. With regards to missing the pill, there are certain precautions that need to be taken for the protection to continue. If you've missed just one pill anywhere in the pack you're still protected against pregnancy because of the cumulative effect of the previous pills. Nevertheless it is still recommended that you should just take the last pill you missed as soon as you remembered, even if this means taking two pills in the same day. The rest of the pack is to be continued as normal. The same advice is given if two consecutive pills are missed. Beyond two days, the protection is lost and generally additional contraception is recommended. The use of placebo pills after 21 days of active pills is to induce a withdrawal bleed. You are protected against pregnancy on the days of using the placebo because of the cumulative effect of the preceding 21 pills. Even if you take continuous pill packs, the placebo pills should be taken only for a week and not any longer. Discuss these issues and the other contraceptive options available in detail with your doctor or nurse or healthcare provider so that he/she may tailor your contraceptive regimen to suit your needs.

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