Withdrawal Bleeding (Combination Birth Control Pill)

[Nomoredream48]

Hello! I have been on combination birth control pills (Yasmin) for a few years but only a few months ago found out that the bleeding I was experiencing every month is called 'withdrawal bleeding'.
I use the 21-day pill packs and go 7 days without any pills, which is when I bleed. I had a few questions about combination birth control pills/withdrawal bleeding that I've found conflicting information for online:

1. Is withdrawal bleeding (4-5 days of continuous bleeding, filling up pads) that happens during the pill-free week a reliable indicator of not being pregnant? Why or why not?
2. Is the same monthly withdrawal bleeding an indication that the birth control pill is working effectively to prevent ovulation, thicken cervical mucus etc.? If not, is there any other easily-accessible way to determine if my pills are working, short of visiting a doctor?
3. Are very rare, tiny amounts of breakthrough "spotting" normal for people that have been on birth control for years? Can extreme stress cause people to experience breakthrough spotting while they are on the pill?

Thank you!

[Nicole]

Hi Nomoredream48,
I am happy to help answer these questions! I can also recommend some of our articles with more information, I will link them at the bottom of my response.
1. Combo pills have a 99.7% effective rate if taken perfectly, so if you are bleeding continuously during the withdrawal period, then you are not pregnant. It is very unlikely to have heavy bleeding over a span of days and be pregnant.
2. If you are taking your pills as directed, then they should be working effectively. The monthly withdrawal bleeding is a very likely indication that the pill is working.
3. It is possible for some uterine lining to build up and shed itself, even when it is not the withdrawal period, which causes the spotting. It is also likely for stress to cause spotting.
I tried to answer your questions in a clear and direct manner to avoid any confusion, since you mentioned that you found contradicting information from various resources. Here are the articles I mentioned in the beginning of my post:

• Birth Control Bingo: The Combination Pill

• Quick Hits: Questions and Answers on The Pill

• Have a Little Faith in BC

Please let me know if you need further clarification! Take care.

[Nomoredream48]

Thank you so much for your response and the resources!

[Nicole]

No problem! Please let me know if you need any further assistance.