On birth control for 2 years. during placebo week, i have cramps, bloating, diarrhea, but no bleeding. have no other symptoms. need to be concerned?

No: The lack of bleeding is primarily due to the low dose of estrogen in your pills. It simply doesn't stimulate much growth of endometrium (uterine lining). Periods are often extremely light to nonexsistent with the low dose pills. If it is worrying you see your doctor. There are alot of pills out there and another one might be better for you.

Not really: sometimes changing pills helps or sometimes I have the patient skip the placebos and just take constant BCPs. this way there is no period week and the symptoms may not occur. occasionally this may be a sign of endometriosis, but usually the pain is less consistent and often painful sex accompanies it.