Patient: I have been taking microgynon 30 contraceptive for about 10 years now. I occasionally take 2 packets back to back with no break if it is inconvenient. However I have recently taken 4 packets back to back for various reasons (holiday and new relationship). I am now 2 weeks into my fourth packet and I have having alot of breakthrough bleeding. I know that I need to have a break and have a period in order for this to stop. My question is this; if stop taking the pill now (2 weeks into the 4th packet)and have my 7 day break to allow myself a bleed, will I be protected when I start taking a new packet after the 7 days like usual. Or will it be like I have missed 7 pills in a row and therefore not be protected? I would have thought I would be protected having taken 3 and a half packets in a row as normally you only need to take 21 pills in a row before you have your break and you are still protected during your break and after.
Doctor: I realize how worried you are about your breakthrough bleeding while taking contraceptives. Ideally you should take this contraceptive every day for 21 days and you then have a seven day break from pill-taking. During your seven day break, the levels of the hormones in your blood drop, which results in a withdrawal bleed that is similar to your normal period. You start the next pack after the seven pill-free days are up, even if you are still bleeding.The best day to start taking this medication is the first day of your menstruation, I hope that you did it is this way, because this might be the reason of your breakthrough bleeding. I don’t suggest you to stop taking them now. In my opinion you should continue taking your pills as indicated. If in the next cycle you experience spotting or intermittent bleeding, a visit to your gynecologist might be needed to rule out other possibilities besides contraceptives effects.