OCs, breakthrough bleeding, and patients’ need to know

Choosing an OC with a higher quantity of ee may also help, particularly for women using 20 μg pills. When possible, the same progestin should be used.

You may want to start a trial of conjugated estrogen, 1.25 mg, or estradiol, 2 mg, administered for 7 days when bleeding occurs. This can be repeated if necessary; however, if breakthrough bleeding continues despite this treatment, consideration of a different pill or method should be undertaken.