<s>[INST] Im a 38 year old woman,I have been on birth control for the past year with no issues until this past month.I have been experiencing spotting a week before I finished my birth control and not having a normal period,what is the answer,could I be pregnant or just my pills arent strong enough? [/INST] Hi, The possibilities in this situation are the development of hormonal imbalances perhaps due to weight gain secondary to pill intake which in turn could have created the need for a higher dose or failure of the pill or disturbances of the hemopoietic system secondary to pill intake. In this scenario, I would ask you to see your consultant for a complete evaluation including blood profile, urinalysis, pregnancy test, sonogram and monitoring. Please maintain a healthy weight and a healthy diet. Take care. </s>