I was on Orlissa and spotting is normal. I was on the max dose for the max amount of time a few years ago, so don't remember how long it took to help my symptoms, but it did reduce my symptoms because I had stopped geting my period while on Orlissa. For me, no period = no pain!! However, when I completed my treatment of Orlissa, the pain came right back. I got my period again and the pain came full force. Wishing you the best and hoping you find relief.