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The first few months, and what your periods will do

Most methods that get abandoned are abandoned in the first three months.

Lesson 3 of 5

10 min Text

What this lesson says

  • Irregular spotting in the first three to six months is a recognised pattern on most hormonal methods
  • A hormonal IUD, the implant and the injection commonly make bleeding much lighter or stop it
  • A copper IUD commonly makes periods heavier and more painful at first
  • Periods stopping on a hormonal method does not damage later fertility
  • A change that starts long after you settled is different and should be looked at

This is general education. It is not advice about your own situation, and it does not replace seeing a clinician.

Written lesson.
  1. 1. Bleeding changes are the commonest effect of hormonal contraception. They are expected rather than a sign that something has gone wrong, and the single biggest predictor of whether a woman stays on a method that would have suited her is whether anybody told her that in advance.
  2. 2. What to expect depends on the method. A hormonal IUD, the implant and the injection commonly make bleeding much lighter or stop it altogether. Pills tend to make it lighter and more predictable, with spotting in the early months. A copper IUD, which contains no hormones, commonly makes periods heavier and more painful, particularly for the first three to six months.
  3. 3. The first three to six months are the settling-in period for most methods. Unscheduled spotting in that stretch usually improves, and knowing that is the difference between waiting it out and abandoning something that was going to work.
  4. 4. Periods stopping on a hormonal method is not a sign that anything is building up inside and it does not damage later fertility. If you have also missed pills or are unsure, take a pregnancy test — that is the only thing that settles it.
  5. 5. What is different is a change that starts long after you had settled. That should be looked at rather than attributed to the method. So should bleeding that becomes heavier rather than lighter, and any bleeding that comes with pain, fever or offensive-smelling discharge.
  6. 6. Spotting can also be caused by an infection, a missed pill or another medicine. Those are worth excluding rather than assuming.

All lessons in this course

  1. 1 What actually separates the methods 11 min
  2. 2 Suitability, and why it is a conversation rather than a counter 12 min
  3. 3 The first few months, and what your periods will do 10 min Reading now
  4. 4 Emergency contraception, and the windows 9 min
  5. 5 What the public health system provides 8 min

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