Should oral contraceptive pills be started during intermenstrual bleeding or only after getting periods?

Question

Hello doctor,

I have an intermenstrual bleeding problem that started on day seventeen of my cycle. I have not gotten my period yet and still have brown and black discharge. My local gynecologist suggested I begin with oral contraceptive pills from day two of my cycle, but I am yet to get my periods. Should I wait or start with my oral contraceptive pills? The last period I got was at the beginning of the month.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your history and understand your concerns. As per your description, these symptoms could be due to hormonal imbalance. But as you missed your period, it could be an anovulatory cycle. Get your pelvic ultrasound to see if the endometrial thickness is appropriate. If Mirena (hormonal intrauterine device) is inserted, pelvic ultrasound with dilatation and curettage might also be required. Get your thyroid profile and hemoglobin test also. For excessive bleeding, you can use Tranexamic acid.

Feel free to ask for more information.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Kindly send a picture as I cannot open the report copy (attachments have been removed to protect the patient's privacy).

Thank you.