Progestogen-only contraception commonly causes breakthrough bleeding
Clinical literature consistently demonstrates that progestogen-only contraceptives frequently cause irregular, unscheduled, or breakthrough vaginal bleeding, which is a primary reason for discontinuation.
The retrieved papers include studies and reviews that explicitly discuss irregular, unscheduled, or unfavorable vaginal bleeding (breakthrough bleeding) as a well-known side effect of progestogen-only contraceptives and implants. There are no refuting papers.
Vercellini P, Salmeri N, Bandini V, Conca B, Viganò P, Somigliana E, Vignali M. Medical Treatment for Endometriosis: One Size Does Not Fit All.. 2026. https://doi.org/10.3390/jcm15062408
Notes that the main adverse effect of progestogens used in clinical treatment is irregular bleeding.
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Torelli FR, Rodrigues-Peres RM, Monteiro I, Lopes-Cendes I, Bahamondes L, Juliato CRT. Gene expression associated with unfavorable vaginal bleeding in women using the etonogestrel subdermal contraceptive implant: a prospective study.. 2024. https://doi.org/10.1038/s41598-024-61751-7
Investigates unfavorable vaginal bleeding and breakthrough bleeding associated with progestogen-only contraceptive implants.
Steinfeldt M, Lora Matos AD, Cu C, Heinrich C, Hartman C, Gibson E, Becerra Mateus JC, Al Abosy J, Abedi P, Jahanfar S. Treatments of unscheduled vaginal bleeding due to progestin-only contraception.. 2024. https://doi.org/10.1002/14651858.cd015441
Discusses treatments for unscheduled vaginal bleeding specifically resulting from progestin-only contraception usage.
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