NAPLEX (North American Pharmacist Licensure Examination) Practice Exam

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What is a recommended action if breakthrough bleeding and spotting persists and the current dose is less than 30 mcg estrogen daily?

  1. Decrease estrogen intake

  2. Change to a progestin-only pill

  3. Increase estrogen intake

  4. Stop using hormonal contraceptives altogether

The correct answer is: Increase estrogen intake

If breakthrough bleeding and spotting persists while on a daily dose of less than 30 mcg of estrogen, it may be an indication that the estrogen dosage is not high enough to effectively control bleeding. In this case, increasing the estrogen intake can help to alleviate the symptoms and provide better protection against pregnancy. Decreasing estrogen intake or switching to a progestin-only pill may not address the underlying issue and could potentially worsen the symptoms. Stopping the use of hormonal contraceptives altogether should not be the first course of action without first consulting with a healthcare provider. Hormonal contraceptives have been shown to be highly effective in preventing unwanted pregnancies and their benefits should be weighed against any temporary side effects. Consulting with a healthcare provider can help determine the best course of action for managing breakthrough bleeding and spotting.

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