What is the appropriate response for a 16-year-old female experiencing midcycle spotting while on Ortho-Novum 7/7/7?

When a 16-year-old female experiences midcycle spotting while taking Ortho-Novum 7/7/7, providing reassurance is the most appropriate response. Midcycle spotting, or breakthrough bleeding, can be a common occurrence, especially when a patient is first starting hormonal contraceptives. In many cases, this bleeding resolves on its own as the body adjusts to the hormones. It’s important to remind the patient that this is often a normal side effect and may not indicate any serious underlying issue.

Reassuring the patient helps to alleviate anxiety and provides her with the understanding that her body is undergoing adjustments. If the spotting continues or is accompanied by other concerning symptoms, further evaluation may be warranted; however, immediate medical interventions like discontinuing the pill or scheduling an ultrasound may not be necessary at this point. Suggesting a different contraceptive method could be an option if the spotting continues over time, but the initial step is often reassurance, allowing time for adjustment before making significant changes.