Does spotting from withdrawal with 24+4 combination tablets have to appear every month?

Withdrawal bleeding should occur while taking placebo tablets, as this is an artificially induced reaction resulting from a break in the supply of hormones from the tablet. The absence of withdrawal bleeding can occur in several cases. The first option is pregnancy - it should be taken into account especially if the tablets would not be taken correctly. Withdrawal bleeding may also not occur despite the absence of pregnancy when the endometrium does not grow enough during the cycle to exfoliate. This is influenced by the hormones themselves contained in the pill, especially if it is a low-estrogen contraception. Exceptionally, the absence of withdrawal bleeding may be associated with gynecological abnormalities. If this situation is repeated, and the patient has ruled out pregnancy, then it is worth consulting a gynecologist. I enclose additional information: https://www.gdziepolek.pl/artykuly/antykoncepcja-hormonalna https://www.gdziepolek.pl/kategorie/tabletki-antykoncepcyjne-dwuskladnikowe