Illustration by Katrin Friedmann
Do you still get your period on hormonal birth control?
Withdrawal bleeding on the pill, patch, and ring
Top things to know about withdrawal bleeding:
Your “period” while using combined hormonal contraception (the pill, the ring, the patch) is called withdrawal bleeding. It happens when hormone levels drop during the hormone-free interval
Withdrawal bleeding is usually lighter and slightly different than the period you had before taking the pill (or using the patch or ring), and it can change over time
Some people experience only very light bleeding or none at all during the hormone-free interval
You can use Clue to set reminders for taking your birth control and to track withdrawal bleeding. This can help you maintain a consistent schedule, record any changes, and know what to expect
Do you still get a “period” on the pill, patch, or ring?
When you’re using a combined hormonal contraceptive (like the combined pill, patch, or vaginal ring), you may notice bleeding during the days you’re not receiving hormones. This normally occurs when you take inactive pills, have a patch-free week, or remove the ring for several days. It’s often referred to as the placebo or hormone-free interval.
The bleeding that occurs during this interval is known as withdrawal bleeding, and it’s usually lighter and different from the regular period you’d have if you weren’t using hormonal birth control (1). In some cases, you may bleed very little or not at all (2).
This article focuses on combined hormonal birth control methods (those containing both estrogen and progestin). If you’re using the progestin-only minipill, IUD, shot or implant, your bleeding patterns may be different.
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Is withdrawal bleeding a “real” period?
No. The bleeding you experience while using certain hormonal birth control methods (or right after you stop or switch to a new one) is called withdrawal bleeding, which isn't the same as a “real” period (1).
What is a period, exactly?
A period (menstruation) is the shedding of the uterine lining that occurs after an egg is released (ovulation) and not fertilized. If fertilization doesn’t happen, hormone levels drop, and the uterine lining (endometrium) is shed (3).
Why is my bleeding different on hormonal contraception?
Combined hormonal methods (the pill, patch, or ring) prevent ovulation and keep the uterine lining thinner (2). As a result, you may experience bleeding that looks and feels different from menstrual bleeding. For example, it might be (4):
Shorter or lighter
Brownish instead of bright red
Spotty, or you may not bleed at all
Not bleeding or only spotting can be more common if you’re using a method with a higher dose of estrogen (ethinylestradiol) or with a shorter (4 or fewer days) hormone-free interval. A shorter hormone-free interval limits the time without hormones, which can reduce withdrawal bleeding. (5,6). Some people notice their withdrawal bleeding gets lighter or disappears over time.
However, not bleeding can sometimes signal pregnancy, so if you’ve missed pills or think there's a chance you could be pregnant, consider taking a pregnancy test (7).
Do I ovulate on combined hormonal contraception?
No. If you take your pill (or use your patch or ring) correctly and consistently, you shouldn’t ovulate. That’s how these methods primarily prevent pregnancy (2).
In a typical menstrual cycle, changing hormone levels tell your body to prepare and release an egg, and to build up the lining of the uterus to serve as a cozy place for the egg in case it is fertilized.
When you use combined hormonal contraceptives, this cycle is disrupted. Your ovaries don’t release eggs, and your uterine lining stays thinner (2). Without ovulation, you don’t experience a “real” period. Instead, the bleeding you see during your placebo or “off” days is withdrawal bleeding, caused by the drop in hormone levels, not the shedding of a thickened uterine lining, like during a “natural” period (1).
When does bleeding start and how long does it last?
The bleeding you experience can depend on the type of hormonal birth control you take and your hormonal patterns. If you’re on a 21/7 monophasic pill (21 active pills all containing the same hormone levels, followed by 7 placebo pills), withdrawal bleeding often starts on day two or three of your placebo week and lasts around 3–5 days. Some people might bleed for only one day, or their bleeding may stretch into the next pill pack. Others—about 1 in 10—won’t have any withdrawal bleeding (not counting spotting) (4).
Bleeding on the pill often decreases over time. In people using the 24/4 day pill (24 active hormone pills, four placebo pills), about 1–2 in 10 have no significant withdrawal bleeding by the 6th pill pack (5).
What is the bleeding that happens outside my scheduled withdrawal bleed called?
Breakthrough bleeding is any bleeding or spotting that happens outside your usual withdrawal bleeding time. While it can be a frustrating side effect, it doesn’t usually mean your birth control method isn’t working (3). It often occurs in the first few months of using a new hormonal method, as your body adjusts to the hormones (2). Breakthrough bleeding can also be triggered by missed or late birth control pills, due to the drop in hormone levels (8).
Can I skip my withdrawal bleeding?
Yes. Many people choose continuous use and skip the placebo pills (or the break between rings/patches) to avoid withdrawal bleeding entirely. This could be due to a medical reason, like migraines, anemia, a history of blood clots, or premenstrual dysphoric disorder (PMDD) (9).
However, you don’t need a medical reason to skip your period. While some find withdrawal bleeding reassuring, there’s no medical need to bleed each month (10). If you’d like to learn more about safely skipping your withdrawal bleeding, read our article on using the pill to skip your period.
What kind of bleeding is considered normal while on hormonal birth control?
Unexpected bleeding or spotting during the first few months of using a new hormonal contraceptive method. If this continues past three months, you should consult your healthcare provider
Withdrawal bleeding that’s lighter or shorter than the period you had before starting birth control
Slight changes in withdrawal bleeding over time
Little or no bleeding during your placebo week (as long as you’ve taken your birth control method correctly (2))
Summary
Withdrawal bleeding happens because your hormones drop during the placebo or hormone-free days
It’s not a “real” period because ovulation doesn’t occur
Withdrawal bleeding is often lighter, shorter, and can look different than a “real” period
It may change over time; sometimes you may experience no bleeding at all
If you’re worried about changes in your bleeding, take a pregnancy test or talk to your healthcare provider
You can use Clue to set reminders to take your birth control and track your withdrawal bleeding, as well as any other symptoms you might notice. Tracking these details can help you spot patterns and stay informed about your reproductive health.
Keep in mind that if you miss a pill (or forget to replace your patch or ring), it’s not safe to rely on Clue’s fertile window as a backup method, since Clue can’t accurately predict your fertile days in this case. You can use Clue to set a daily pill reminder or to tell you when it’s time to start a new pack so that you do not extend your hormone-free interval.
FAQs
What does a withdrawal bleed look like?
It’s usually lighter than a “real” period and can be brownish instead of bright red. Sometimes it may be spotty, or you might not have any bleeding at all (2).
Does withdrawal bleeding mean I’m not pregnant?
Not necessarily. While bleeding can be a sign that your hormone levels have dropped as expected, it doesn’t guarantee that you’re not pregnant (11). If you missed or skipped oral contraceptive pills and feel uncertain, take a pregnancy test to be sure.
Can birth control make you bleed if you stop taking it?
Yes. When you stop using hormonal birth control (or switch to a different method), the sudden change in hormone levels can trigger withdrawal bleeding (2). This happens even if it’s not time for your usual placebo or hormone-free days.
