In the years coming up to your final menstrual period, you can experience several years of fluctuating hormone levels. This time period is known as perimenopause, and it can cause some challenging symptoms.
Taking hormonal birth control, like the pill or a hormonal intra-uterine device (IUD), during perimenopause can reduce the chance of pregnancy (if you don’t want to become pregnant) and might play a role in symptom management.
Birth control and perimenopause
Perimenopause is the period of time shortly before menopause. Menopause begins when you haven’t had a period for 12 months in a row. The perimenopause lasts 4 years, on average, and usually starts in your mid-to-late 40s, but this differs from person to person.
During perimenopause, your hormone levels will change as your ovaries make different amounts of progesterone and estrogen. You might experience changes to your periods, where they are shorter, longer, or irregular. Flow might be different than usual.
Some other common perimenopause symptoms include:
- worsening premenstrual syndrome (PMS)
- weight gain
- hot flashes
- vaginal dryness
- changes to sex drive
- headaches
- confusion and forgetfulness
- muscle aches and pains
If hormonal contraception is safe for you, it might also help with perimenopausal symptoms. Low dose hormonal birth control might be an option you consider.
Hormonal birth control is safe for use during perimenopause if you are over the age of 35 and do not have certain health conditions.
The Centers for Disease Control and Prevention (CDC) generally recommends that people continue to use birth control until they reach menopause but that they weigh the chance of unplanned pregnancy later in life versus the health risks that might come with contraception.
Hormonal birth control options
There are potential benefits of using hormonal birth control during perimenopause. According to the North American Menopause Society (NAMS), hormonal birth control can:
- reduce hot flashes
- reduce menstrual bleeding
- promote regular menstrual cycles
- maintain bone strength
- decrease uterine pain during menstruation
- improve acne
Hormonal birth control can also help with urinary issues during perimenopause.
Hormonal birth control options do come with risks. Oral contraceptives may increase the chance of breast and cervical cancers but reduce the chance of endometrial, ovarian, and colorectal cancers.
The four main types of hormonal contraception are:
- the pill
- hormonal IUD
- skin patch
- the shot
The pill
The birth control pill comes in two types: the progesterone-only pill (known as the mini pill) and combined oral contraceptives (COC). Combined pills have both progesterone and estrogen.
A doctor might recommend that you avoid the COC if you have a history of breast cancer. The COC also increases the risk of blood clots. The risk of stroke and heart attack in women taking COC goes up with increased age, higher estrogen dose, and cardiovascular risk factors such as:
- smoking
- hypertension
- diabetes
- obesity
- hyperlipidemia
If you have one of these risk factors, a doctor might recommend a low dose estrogen birth control pill or another birth control method that does not contain estrogen.
Branded examples include:
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