Birth control pills help regulate the hormone levels in a woman’s body and are designed to prevent pregnancy. However, these pills also offer a bonus: they have the ability to reduce the occurrence of one of the “hottest” menopausal symptoms: hot flashes. So here’s a burning question: can birth control pills help perimenopause symptoms as well?

Experts come down on both sides of this question. But one thing seems to be clear: birth control pills have a positive effect on hot flashes. Since hot flashes are a symptom of perimenopause, why not take the pills to help relieve these and other perimenopausal symptoms? Good question.

What is perimenopause? 

First of all, perimenopause is the period of approximately a few months to 10 years (average, 4 years) before menopause, when the ovaries completely stop releasing eggs. Perimenopause is characterized by changes in estrogen levels that can occur rapidly during the last 1 to 2 years. Perimenopause is over when women have not had a period for 12 months.

The most common symptom of perimenopause is irregular periods, but women may also experience hot flashes, breast tenderness, reduced sex drive, fatigue, vaginal dryness, urine leakage, urinary urgency, trouble sleeping, and mood swings. The likelihood of these symptoms occurring can increase as women advance from early perimenopause to the late stages.

What should you know about birth control pills?

The two main types of birth control pills are combinations and minis.

• Combination pills contain both estrogen and progestin. Their main job is prevention: they stop the release of an egg each cycle and the fertilization of an egg by sperm. To accomplish this latter task, the pills make the cervical mucus thicker and the lining of the uterus thinner. The subtypes of combination pills are those that are taken on a continuous basis (every day) or on a 28-day cycle. The active combination pills can contain either the same amount of hormone throughout each cycle or the amount of hormone can vary.
• Mini pills contain progestin-only. These are frequently taken by women who are breastfeeding. These pills generally thicken the cervical mucus and thin the uterine lining, although sometimes they also prevent ovulation.

Because the hormones in birth control pills cover up the natural decline in hormones associated with perimenopause and menopause, they can be helpful in relieving perimenopausal symptoms. In addition, the pills may help reduce the loss of bone density, relieve anxiety and depression, and ward off brain fog.

What you can do

If you and your doctor decide you can take birth control pills to help with perimenopausal symptoms, there are a few factors that need to be considered. Foremost is your current state of health. If you fall into any of the following categories, the combination birth control pills are likely not for you. Those categories include:

• Age 35 or older and a smoker
• Hypertension
• Diabetes
• History of stroke or blood clots
• Obesity
• Migraines
• Liver disease
• History of an estrogen-dependent tumor

Women who have any of these issues should talk to their healthcare provider about their options. If these factors are not part of your profile, then the combination pills may serve you well. However, you should still discuss this plan with your physician.

What to discuss with your physician

When you talk to your doctor about taking birth control pills to help manage perimenopausal symptoms, you should be aware of the risk factors. Many studies show that taking these hormones may slightly increase your risk for breast and cervical cancers. However, use of combination pills also seem to reduce the risk of colorectal, ovarian, and endometrial cancers.

Since your past and current health profile differs from that of anyone else, you need to discuss your options with a knowledgeable healthcare provider. Then you and he or she can determine whether birth control pills are right for you during perimenopause.

Bottom line

It appears birth control pills can be used to help relieve symptoms of perimenopause. However, you should discuss the potential risks with a qualified healthcare provider before you begin taking them. They could well help you sail through perimenopause!