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Last year I began taking Adderall and shortly after had some spotting/breakthrough bleeding mid month despite being on Ortho-low for year with none of this. My doctor told me that sometimes due to the raise in your metabolism (from the adderall/stimulant) your body will need a higher dose of certain medications. However, it is possible that if you have been on the pill (any one) for years, that your body has simply developed a tolerance to it and you will need to switch medications. Talk to your doctor.

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Q: Will Adderall cause breakthrough bleeding
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