Are you bleeding every day?
Which pill are you on?
Do you miss any pills?
Did you originally start the pill during a period?
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The tissue in the photo is suspicious for a pregnancy sac, although it could possibly be uterine lining. Occasionally the uterine lining comes out almost intact, often associated with pain. I would recommend placing the tissue in the freezer and bringing it with when you see the doctor. A microscopic exam will reveal what it is.
Women often have more breakthrough bleeding during the first few months on the pill if they don't start taking it during a period. Usually it resolves itself after 2-3 months, but not always. If it doesn't, then usually changing the pill will resolve the bleeding. I would discuss that with your doctor when you go.
Perhaps now that the tissue has been expelled, things will settle down for you. By the time you see your doctor, you may not have any further problem. Best wishes.
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