The Vestura Cycle: Active vs. Inactive Pills
Vestura is a combination birth control pill containing synthetic versions of the hormones estrogen (ethinyl estradiol) and progestin (drospirenone). It works primarily by preventing ovulation, but also by thickening cervical mucus and thinning the uterine lining. A typical 28-day Vestura pack consists of 24 pink active tablets and four peach inactive (placebo) tablets.
- Active Tablets (Days 1-24): These pills contain the hormones that prevent pregnancy. Taking these consistently suppresses ovulation and maintains a steady hormone level in your body.
- Inactive Tablets (Days 25-28): These pills contain no hormones. The drop in hormone levels during this time triggers the uterine lining to shed, which results in withdrawal bleeding. This scheduled bleeding is not a true menstrual period, as ovulation does not occur while taking the active pills.
Withdrawal Bleeding Explained
Withdrawal bleeding on Vestura is a predictable response to the drop in hormones during the placebo week. It's typically lighter and shorter than a regular period would be off hormonal birth control, and some users may experience very light or no bleeding at all over time. The purpose of this scheduled bleed is simply to mimic a natural cycle, but it is not medically necessary. A withdrawal bleed is a sign that the hormonal suppression is working as intended.
Breakthrough Bleeding vs. Withdrawal Bleeding
It is important to differentiate between the scheduled withdrawal bleed and breakthrough bleeding. Breakthrough bleeding is any bleeding or spotting that occurs during the 24 days you are taking the active hormone pills.
- During the first few months: Breakthrough bleeding is most common during the first 1-3 months as your body adjusts to the hormones. This is usually temporary and not a cause for concern. If it persists beyond three months, or becomes heavier, it is wise to consult a healthcare provider.
- Causes of breakthrough bleeding: For some, breakthrough bleeding can occur due to missing a pill or taking it at inconsistent times. Certain medications and herbal supplements, like St. John's wort, can also decrease the pill's effectiveness and lead to breakthrough bleeding.
What to Do If You Miss a Period on Vestura
It is not uncommon to miss a withdrawal bleed while on Vestura. In fact, 6-10% of women in contraception trials experienced cycles with no withdrawal bleeding, even when not pregnant. This is often the result of the uterine lining becoming very thin over time due to the consistent hormone delivery.
However, a missed bleed can also be an indication of pregnancy, especially if pills were missed during the active phase. It is crucial to follow the directions for missed pills provided in the package insert or by your healthcare provider. If you have missed doses and then miss a period, it's recommended to take a pregnancy test. If you have consistently taken your pills correctly and miss two consecutive periods, you should also rule out pregnancy.
How to Manage Your Bleeding with Vestura
One of the benefits of a combined pill is the ability to manipulate your bleeding schedule. By skipping the inactive placebo pills and immediately starting a new pack of active pills, you can delay or stop your withdrawal bleed. This is a safe and effective way to manage your cycle for convenience, such as during a vacation or special event. However, when doing this, you might experience some breakthrough spotting, particularly when you first start.
Comparative Bleeding Patterns on and off Vestura
| Feature | Natural Period (without birth control) | Withdrawal Bleeding (on Vestura) |
|---|---|---|
| Hormonal Cause | Natural rise and fall of ovarian hormones, leading to ovulation and subsequent shedding of the uterine lining if pregnancy doesn't occur. | Drop in synthetic hormone levels during the placebo week. |
| Ovulation | Occurs naturally each month. | Is prevented by the active hormones in the pill. |
| Bleeding Amount | Varies significantly by individual, can be heavy. | Typically lighter and shorter than a natural period. |
| Associated Symptoms | Can include significant cramping, headaches, and PMS symptoms. | Some period-like symptoms may still occur, but are often milder. |
| Predictability | Can be regular but is subject to variation based on a number of factors. | Highly predictable, occurring during the inactive pill week. |
Conclusion: Periods, or Something Different?
So, do you get periods on Vestura? While you will experience a predictable, monthly bleed, it's not a true menstrual period. Instead, it is a lighter withdrawal bleed caused by the temporary absence of hormones from the inactive pills. This pattern is normal, though some users may experience irregular bleeding or no bleeding at all, especially initially. Understanding your pill schedule and what to expect can provide peace of mind. As always, for any persistent or concerning changes in your bleeding pattern, or if you miss two consecutive withdrawal bleeds, consult your healthcare provider.
