Skipping Placebos, Breakthrough Bleeding

Patient: I am a 28 year old female, started birth control (Vestura) for the first time in late January, and was advised by my Gynecologist to skip the placebo pills which I have been doing. I never miss a pill and always take one within 30 minutes of the same time each day. I had breakthrough bleeding, as expected, during the first 3-4 months of skipping the placebo pills, but then was able to miss my periods completely for a few months. Now I am seeing breakthrough bleeding again. While it is not necessarily heavy bleeding, it is a continuous, not light, flow for 3-5 days. Should I be worried about this?

Doctor: