If you have been taking birth control pills, you might be wondering whether or not to continue with this form of birth control. Is ‘the pill’ necessary during peri-menopause? Are birth control pills better than hormone replacement therapy? What are the health risks? Answering these questions means understanding what is happening to your body and determining the right course of action for you.

Knowing when perimenopause starts
Women who have been taking birth control pills will not know that they are perimenopausal compared to women who have not taken birth control pills. This is because birth control pills interfere with the natural monthly ovulation cycles. Each month, three weeks of active pills are followed by one week of placebo pills; the menstrual period is due to the hormonal withdrawal during the placebo week. Some women opt to have their periods even less frequently, as little as once every three months.

Birth control pills provide more hormones than the ovaries usually produce, and the constant regular dosage ensures those hormonal levels are balanced. When taken correctly, birth control pills will prevent many of the traditional symptoms of menopause under control, including hot flashes and night sweats or mood swings and insomnia. As a result, many women will be less in tune with the natural rhythms of their bodies and may not even be aware that peri-menopause is taking place!

Should I stop taking my birth control pills?
At some point, every woman will stop taking birth control pills. But because perimenopause is such an inexact event, it is difficult to know when the time is right. Coming off birth control pills means you body reverts to its natural state and the decreasing levels of hormones. It can take as long as 18 months for your body to get back to its natural state, all the while you still have to deal with having periods. Or you may be subjected to some very erratic monthly cycles and there is still the risk of pregnancy.

Talk to your doctor
Your doctor will take many factors into consideration when helping you decide when and how to stop taking birth control pills. Your age, physical health, and whether you smoke or drink alcohol will all play a role. Some women will find that staying with birth control pills, usually lower dose versions, will be very helpful in reducing or eliminating perimenopause symptoms. Compared to traditional hormone replacement therapy options, lower dose pills can have fewer side effects or health risks.

Birth control and perimenopause
During perimenopause there is still the risk of pregnancy. Your doctor can help find a lower dose pill to stave off unexpected pregnancies. You may also want to consider alternative contraceptive methods if you stop taking birth control pills altogether. Until a woman is considered full menopausal – a full 12 months without having a period – pregnancy is still a very real possibility.

At the same time, your doctor can conduct a test to determine your fertility. A FSH (follicle stimulating hormone) test measures this hormone’s levels. Often, this test is necessary because it can be difficult to know how fertile you are after years of using birth control pills.

Coming off ‘the Pill’ puts you more in tune with your body; this can be difficult if you begin to experience perimenopausal symptoms. While some women find it beneficial to know that they have entered peri-menopause, others may simply experience more anxiety and frustration.

Deciding whether or not to stop taking birth control pills is not an easy decision. It can take a while for your body to re-regulate itself and you may find yourself in the middle of all this upheaval just when you do not need it. Yet women cannot stay on birth control pills indefinitely. Talk to your doctor to begin exploring the many options available to you and make the right decision based on what is right for your body.

Menopause, Your Doctor, and You