I think my progestogen only contraception is making me bleed, what should I do?

Progestogen only contraception includes the implant, the injection and the progestogen only pill. If you're using one of these methods and think it might be causing your irregular bleeding, there are a few things you can try. 

Taking the pill as well

If you’re using the implant or contraception injection then you can take the combined pill continuously as well. But this is only a short-term solution. And you’ll need to speak to your GP or a clinician at your sexual health clinic to check it’s safe for you.

It can give you a break from bleeding and give the irregular bleeding a chance to settle down. It also gives you time to think about if you want to change your method of contraception.

There’s no research to show the effects of using the implant or injection as well as the combined pill in the long-term. So at the moment, it’s only recommended to combine them for 3 months.

When you stop taking the pill, your bleeding pattern will still be affected by the implant or injection. It might stay irregular or it might have stopped or settled into a regular pattern.

Waiting 3 months

If you’re having irregular bleeding during the first 3 months of starting a new contraceptive method, then it’s waiting to see if it improves. 

For some methods, like the implant, bleeding usually does not improve over time. At the 3 month point, whatever your bleeding pattern is, it’s likely to stay that way.

For other methods, improvements to your bleeding pattern will come gradually and should settle by the end of the first year.

Take medication to reduce bleeding

You can take mefenamic acid and tranexamic acid as short-term measures to reduce bleeding, but these are not long-term solutions. Speak to your GP or local sexual health clinic about trying these medications.

Change your contraceptive method

If the irregular bleeding carries on after 3 months, talk to your GP or a clinician at your sexual health clinic about other contraception options. You could try a different method that will not cause irregular bleeding.

There’s no evidence to suggest that using 2 progestogen only methods can improve bleeding, such as combining the implant with the progestogen only pill. Some healthcare professionals will suggest you try this as a last resort, but there’s no research to support it.