early period

i really just need to ease my mind, and i'm hoping you can help me! i am sexually active, and i am on birth control. i do everything correctly, and my period was usually correct also. i am on the birth control patch, and it is my third week, and this coming tuesday is my "off week" (when my period should come)
well, the beginning of this week, i have start spotting. it would come and go, and now it seems as though it's staying.

last month, i joined a gym and i've started working out relatively often (4 times a week) and i also work a full time job and put in sometimes up to 15hours over time a week. i am a healthy person, and i have only had my period be somewhat early once before, but it wasn't nearly as early as this time (this is a week early)

i am wondering, what do you think this means? and, should i expect it to last until next week, when my period should come? do you think this is at all, a sign of pregnancy?

i greatly appreciate any feedback you can give me. i am stressing. i hope i'm stressing over nothing. :)

[Machelle Seibel, MD]

Hi,

It is always a good idea to be sure that your aren't pregnant. Get an over the counter pregnancy test and find out just to be sure. Although that probably isn't the case, it tells us how best to proceed.

Often, when a person is newly on a form of contraception, or when she is on it for a fairly long while, there can be some unusual bleeding patterns. These often resolve themselves but can also  be handled by adding low dosages of hormones (usually low dose estrogen) to the pill/patch for the days of spotting. It is also possible that your weight has changed since going on the birth control patch and your hormonal requirements have changed. You didn't state your age or how long you've been on the birth control patch which might help answer your questions.

It is also possible that the patch is a bad batch. You can look on the box and see the lot# and call the company and see if they have any other complaints from that lot#. You might also be sweating a lot from stress at work and/or working out at the gym and the patch might not be sticking well resulting in poor absorption.

If these things are not the case and you are not pregnant, give it another month. If bleeding still continues abnormally, talk with your doctor about switching the form of contraception or adding a low dose (usually of estrogen) to the patch for the days you are spotting. After a month or two it will usually resolve. It is most likely that there will be nothing to worry about from your symptoms, but it is difficult to say with certainty without an exam and possibly some testing.
Machelle Seibel, MD