How Desogestrel Works to Change Your Cycle
Desogestrel is a progestogen-only pill, also known as the mini-pill, that works primarily by suppressing ovulation. Unlike combined oral contraceptives that contain both estrogen and progestogen and rely on a 7-day pill-free interval to trigger a withdrawal bleed, desogestrel is taken continuously without a break. This continuous, low-dose hormonal effect prevents the uterine lining from building up significantly. The primary contraceptive action is inhibiting ovulation, though it also thickens the cervical mucus, which makes it difficult for sperm to reach an egg.
The continuous nature of the medication and its specific hormonal action are what cause changes to your bleeding pattern. The desogestrel-only pill is often associated with a higher rate of amenorrhea compared to older mini-pills because of its stronger effect on suppressing ovulation.
Potential Bleeding Patterns on Desogestrel
When you begin taking desogestrel, and in the months that follow, your menstrual cycle can behave in several different ways. It’s important to remember that every individual's body reacts differently to hormonal changes.
Commonly observed bleeding patterns include:
- Amenorrhea (No Periods): For many, periods stop entirely. This is a common and expected outcome, especially after the first few months of use.
- Infrequent or Irregular Bleeding: Many users experience sporadic bleeding or spotting between periods, especially during the initial months. A study cited by SH:24 notes that after 12 months, about half of users can expect infrequent bleeding or none at all.
- Frequent Bleeding: Some individuals may experience more frequent bleeding or spotting episodes, particularly at the beginning of treatment. This tends to settle down over time.
- Prolonged Bleeding: A smaller number of people may experience bleeding or spotting episodes that last longer than 14 days.
- Lighter Bleeding: If you do still have periods, they will likely be lighter than before.
These changes are normal and are caused by the body's adjustment to the continuous, low-dose progestogen. Many find that their bleeding pattern stabilizes after the first three to six months.
How to Handle Irregular Bleeding and What is Considered Normal
Breakthrough bleeding, or spotting between periods, is one of the most common side effects of desogestrel. While it can be frustrating, it does not mean the pill is not working, as long as you have been taking it correctly.
Here are some things you should know:
- Stay consistent: Continue taking your pill every day at the same time. Irregular bleeding often subsides after the first few months as your body gets used to the hormones.
- Lifestyle factors: Certain habits, like smoking, can increase the likelihood of breakthrough bleeding.
- When to see a doctor: If the irregular bleeding is very heavy, prolonged, or continues to be a problem after a few months, it's a good idea to speak with a healthcare provider. They can rule out other potential causes and discuss alternative options.
What to Do If You Miss a Period
A missed period while on desogestrel is often a normal occurrence and not necessarily a sign of pregnancy, especially if you have taken your pills correctly. Since desogestrel suppresses ovulation, the endometrial lining doesn't build up in the same way, and a monthly period is not guaranteed.
However, it's crucial to be aware of the following scenarios:
- Pills taken correctly: If you haven't missed any pills and have no other pregnancy symptoms, it's unlikely you are pregnant. A healthcare provider can offer reassurance.
- Missed two consecutive periods: If you miss two periods in a row, it is advisable to take a pregnancy test to be sure.
- Missed pills: If you have missed one or more pills and then miss a period, take a pregnancy test as soon as possible. If the test is positive, stop taking the pill and contact your doctor.
Desogestrel vs. Combined Pill: A Comparison
| Feature | Desogestrel (Progestogen-Only Pill) | Combined Oral Contraceptive Pill |
|---|---|---|
| Hormone(s) | Progestogen only | Estrogen and Progestogen |
| Dosing Schedule | Taken continuously with no break between packs | 21 active pills, followed by a 7-day pill-free break |
| Ovulation Suppression | Yes, in most cycles (approx. 97%) | Yes, reliably |
| Thickens Cervical Mucus | Yes, also a primary mechanism | Yes, but not the primary method |
| Expected Bleeding | Highly variable: amenorrhea, irregular bleeding, spotting, or lighter periods are all possible | Predictable withdrawal bleeding during the 7-day break |
| Bleeding Side Effects | Irregular bleeding and spotting are common, especially initially | Irregular bleeding is less common but can occur, especially with non-adherence |
| Who Can Use | Suitable for many women who cannot take estrogen, including smokers over 35 and those with certain types of migraines | Contraindicated for women with certain risk factors like blood clots, some migraines, and smoking over 35 |
Conclusion
The answer to whether you will still get your period on desogestrel is that your bleeding pattern will likely change and become unpredictable. While some people continue to have periods, they are often lighter. It is also very common to experience irregular spotting or to have your periods stop completely (amenorrhea), a side effect that is more common with desogestrel than with other mini-pills due to its effect on ovulation. For many, the irregular bleeding and spotting seen in the first few months tend to settle down over time. If you have concerns about your bleeding pattern, or if you miss a period after missing pills, it is always best to consult a healthcare professional for guidance.
