Birth Control For Perimenopause – A Good Idea?

March 01, 2020.

There are a lot of opinions about whether or not birth control pills for perimenopause are a good idea. There have been numerous studies, and even large national initiatives to examine this very question. Yet, there is much debate over the subject, even within the medical community. We do know that women need contraception until at least 12 months following their last menstrual period. If birth control can serve as a form of contraception and curb those hot flashes, can it be a win-win?

Do birth control pills relieve perimenopause symptoms?

Birth control pills are a form of hormonal contraception that can help regulate your body’s hormone levels. There are two main forms of birth control pills:

  1. Combination pills These pills have estrogen and progestin. Combination pills can be either conventional, where they follow a “typical” 28-day cycle, or continuous dosing, where you only have a period around 4 times annually. With combination pills, the active pills can either contain the same amount of hormone throughout each cycle (monophasic), or the amount of hormone can vary (multiphasic).
  2. Mini-pills These pills only contain progestin and are frequently utilized by breastfeeding mothers.

Birth control pills work differently based on whether they are combination pills or mini pills. Combination pills aim to prevent ovulation (releasing an egg each cycle) and prevent sperm from fertilizing an egg by thickening cervical mucus and thinning the lining of the uterus. Without estrogen, the mini-pill works primarily by thickening cervical mucus and thinning the uterine lining. Sometimes, the mini-pill also suppresses ovulation.

Birth control can relieve perimenopause symptoms

If you are suffering from any of the 34 symptoms of perimenopause, birth control pills may help relieve your troublesome symptoms. As you approach menopause, your estrogen levels will decline, although not steadily as there can be rapid fluctuations in perimenopause. The synthetic hormones in birth control mask the natural hormonal decline leading up to menopause. Therefore, you may be able to ward off some perimenopause symptoms with birth control pills.

Along with curbing hot flashes and irregular bleeding, birth control pills may help ward off declining bone density that occurs once estrogen levels decline. Furthermore, taking birth control pills for perimenopause anxiety, depression, and brain fog may offer relief.

What are the best birth control pills for perimenopause?

The primary purpose of birth control pills is to prevent unintended pregnancy. Indeed, guidelines from the Centers for Disease Control and Prevention (CDC) recommend that women should use contraception up to 12 months after their last menstrual period. For many women, taking birth control pills can be a win-win as it may offer contraception and symptom relief.

Combination birth control pills may be recommended by your doctor because synthetic estrogen has shown to relieve perimenopause symptoms. However, there are women who cannot safely take the pill because of some of the following risk factors:

  • Women who are 35 and older who smoke
  • Hypertension
  • Diabetes
  • Migraines (especially with aura)
  • Obesity
  • History of blood clots or stroke
  • History of an “estrogen-dependent” tumor
  • Liver disease

There have been many studies conducted to examine the role of birth control pills and cancer risks, particularly breast cancer. While there are many factors that may contribute to an increase in cancer risk, most studies indicate that taking birth control pills may slightly increase a woman’s risk for breast and cervical cancers. Interestingly, studies have also found that the risk for ovarian, endometrial, and colorectal cancers decreases with birth control use.

Am I a candidate for a low dose birth control pill to treat my perimenopause?

Birth control is useful for symptom management in perimenopause. However, you should discuss your personal risk factors with your doctor. Birth control pills are not recommended for everyone. Indeed, the risk factors of taking birth control pills must be weighed against the benefits of taking birth control for perimenopause symptom control.

Every woman is different. Get the conversation started with your doctor to see if birth control pills are a tool to help you survive, and thrive, during perimenopause.

Disclaimer: This is not medical advice, does not take the place of medical advice from your physician, and is not intended to treat or cure any disease. Patients should see a qualified medical provider for assessment and treatment.

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Julia Walker
perry expert Julia (RN, BSN, BA) is a registered nurse based in Colorado. Julia's nursing background in women’s health has ranged from neonatal and postpartum care to labor and delivery, to outpatient gynecological medicine for both adolescent and adult populations. She specializes in helping women optimize their health during perimenopause and beyond.

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