- With Mayo Clinic internist
Sandhya Pruthi, M.D.
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Sandhya Pruthi, M.D.
Sandhya Pruthi, M.D.
Dr. Sandhya Pruthi, certified by the American Board of Family Practice, has been practicing medicine at Mayo Clinic since 1995 with special interests in breast diseases and women's health.
She is a consultant in the Department of Internal Medicine, Division of General Internal Medicine, and the Breast Diagnostic Clinic. She is an assistant professor of medicine at Mayo Clinic College of Medicine in Rochester, Minn.
The Winnipeg, Manitoba, native stresses education and patient-related research and has been active in both areas since joining Mayo Clinic. She is the primary investigator at Mayo Clinic of several clinical trials evaluating new agents for the prevention of breast cancer and identification of biomarkers for early detection of breast cancer. Her other research and clinical interests include managing the health of women who are at increased risk of breast cancer, breast pain and hot flashes, and developing patient education decision-making tools for breast-related concerns. She is director of the Breast Diagnostic Clinic and is a member of the Women's Health Executive Committee. Dr. Pruthi has been newly elected as a member to the board of directors for the American Society of Breast Disease. She has assisted with a variety of articles for MayoClinic.com.
"Having an opportunity to share information with my patients in the way that will help them to understand and be able to make educated decisions about their own health is very important to me," she says.
"The Web has become a major information site for people, and I want them to get the best and accurate information to be able to make informed choices for themselves, their family members and friends."
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Question
Seasonale side effects: Is breakthrough bleeding a concern?
I've been taking Seasonale for about six weeks and have been bleeding for the last week. Should I be concerned? How long will the bleeding last?
Answer
from Sandhya Pruthi, M.D.
Seasonale side effects may include spotting or bleeding between periods (breakthrough bleeding). Although breakthrough bleeding can occur with any birth control pill, it's more likely to occur with extended-cycle birth control pills — such as the combination drug levonorgestrel-ethinyl estradiol (Seasonale) — than with standard 28-day birth control pills. Although annoying, breakthrough bleeding usually doesn't indicate a serious underlying problem.
The cause of breakthrough bleeding with an oral contraceptive isn't always clear. It may simply take time for your body to adjust to the hormones in the medication. In addition, you're more likely to experience breakthrough bleeding if you:
- Miss a pill
- Start a new medication — such as certain antibiotics — that may interfere with the pill
- Become ill with vomiting or diarrhea, which may impair absorption of the medication
Unpredictable bleeding with an oral contraceptive should decrease with time. With Seasonale, this can take up to a year. In the meantime, it's essential to continue taking the medication as directed. Although unlikely, bleeding may persist until your next scheduled period — which can be a fairly long time with Seasonale. Also, don't be concerned if you don't get your next scheduled period after an episode of breakthrough bleeding.
If the breakthrough bleeding becomes heavy or bothersome, contact your doctor. He or she may suggest another method of contraception.
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