Thank you for the details.
Actually, if you are "menstruating" regularly, it is irrelevant to take a pregnancy test.
In the first 3 months of using birth control it is normal to have "spotting"
and it could also be that this type of birth control is just not right for you. Sometimes they will try to increase the estrogen dose of the pill or give an extra dose of conjugated estrogen for 10 days, but all of this needs to go through a medical evaluation first. I also wonder about the causes of the persistent "spotting" after sex.
At this point, I would advise you to see a specialist, such as a gynecologist, to assess whether there is a biological/anatomical cause for this. Following the investigation, if there is still no underlying cause to treat, you could probably benefit from a higher dose of estrogen in your tablets. In the meantime, I would also suggest that you have double protection for sex (condom use), in case your pill effectiveness is affected.
Note that smoking can reduce the effectiveness of birth control pills, and if so, this could explain your condition.
I hope this answers your question.
Maeva Di-Re, Pharmacy Student
Supervised by Alexandre Chagnon, Pharmacist