“Low-dose” birth control pills for perimenopause symptoms
And yet, if we are fortunate to live long enough, we women are guaranteed to go through menopause at some point along the way, and many of us will endure at least some of these of these symptoms at perimenopause and menopause.
Erratic and dropping estrogen is the primary culprit behind many menopause symptoms. Before reproduction shuts down for good at around age 51, rises and dips in hormone levels are responsible for the emotional and physical roller coaster ride many women experience, starting as early as their mid-30s.
One way to manage many perimenopausal symptoms may be a treatment you thought you were done with: the Pill.* Because hormonal birth control provides estrogen at an even, predictable rate, the Pill can smooth the dips and peaks of fluctuations and balance out the hormones you're losing.
For many women, hormonal birth control is an escape (maybe temporary and incomplete, but still an escape) from some of the more disruptive symptoms of perimenopause and menopause. If you're having a hard time of it, and are a good candidate for hormonal birth control (no abnormal clot risk, not a smoker, etc.), a few years on the Pill might be a good way to go.
Why should you use birth control pills for perimenopause?
NOTE: As Dr. Sherry told us, if you’re still having periods, erratic or otherwise, you can still get pregnant. So if you engage in intercourse with men, some sort of birth control is called for. After teens, perimenopausal women have the second highest rate of unintended pregnancies. Remember, however, that the Pill does NOT reduce your risk of sexually transmitted diseases like herpes, so please continue to use condoms.
The Pluses: Low-dose birth control pills can help ease the perimenopause transition for many women by regulating hormones. This can reduce hot flashes, ease mood swings, lessen the menstrual flow, regulate erratic periods, and lessen the impact of endometriosis. According to Harvard Health, birth control pills may also reduce vaginal dryness and prevent bone loss, all while protecting you from endometrial and ovarian cancers and those unintended pregnancies. And, WebMD adds, low-dose birth control pills may also help stave off colorectal cancer.
Risks of low-dose birth control?
Because the amount of hormones is so low, and because current formulations of the Pill are safer than previous versions, there are fewer side effects and risks to fear. Studies show low-dose birth control doesn’t cause weight gain, and vascular issues like deep-vein thrombosis and stroke aren’t generally an issue for women over 35 who don’t smoke.
The Minuses: The risk of increased breast cancer is still a subject of some debate, particularly when it involves women who are older (possibly because they started with the riskier, higher-dose oral contraceptives that were available when they were younger) or who have a family history of breast cancer.
Migraines may worsen with hormonal birth control, and the possibility of blood clots does still exist for some. Pills containing estrogen are not advised for those at risk of cardiovascular disease or hypertension or for those who smoke. Finally, research is being done to determine if birth control pills contribute to vaginal atrophy and painful sex.
[stay tuned for an upcoming podcast with Rachel Gelman, DPT, PT, of the Pelvic Health and Rehabilitation Center
on the effects of birth control]
And because the rates of STDs among the over-50 crowd are increasing (thanks, perhaps, to the advent of that little blue pill), we'll remind you again: the Pill does not protect against sexually transmitted diseases such as herpes, gonorrhea, genital warts, or HIV. Continue to use a barrier method such as condoms to reduce your risk of an STD.
When can I go off birth control?
Because the Pill can mask menopause symptoms – including causing “withdrawal bleeds” during the sugar-pill week – a woman on mixed-hormone oral contraception may not know she’s completed the transition to menopause. Getting an FSH (follicle-stimulating hormone) test during a break from taking the Pill may help a woman and her OB/GYN determine where she is in her menopause journey. The Gennev Menopause Assessment can also help her determine her place in the perimenopause to menopause transition during this break.
When a woman goes off the Pill to get a sense of her cycles (or lack thereof), some research indicates that may be a good time for her to transition from oral contraceptives to HRT (hormone replacement therapy), if she decides to go that route.
There are natural ways to manage menopause symptoms that are highly effective for some women. There are lifestyle choices that can make life during this challenging time easier for others. If you prefer not to take the hormonal route, or can't because of an increased risk of breast or other cancers, you're not out of luck. We highly recommend you talk with a Gennev Health Coach/Dietitian. Our coaches get special training in ways to mitigate menopause symptoms through nutrition, exercise, stress management, sleep hygiene strategies and more.
And for some women, there are birth control pills. There are risks to oral contraceptives, higher for some women than others, so please – do your research, talk to your doctor or one of ours, to make sure the information you’re getting is recent and reliable.
But as always, there is no need (and no medal that we know of) for suffering in silence. Reach out and talk with an OB/GYN or Health Coach to find the solution that works best for your lifestyle, medical history, and current situation.
We’d love to know what you’re doing to make perimenopause/menopause more comfortable. Fill us in in the comments below, or share on the Gennev Facebook page or in Midlife & Menopause Solutions, the closed Gennev Facebook group.
*The information in this blog is for educational purposes only. To understand your potential risks and benefits, talk to a doctor.
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