Women's Health : How to Stop Birth Control Pills During Pre-Menopause
Birth Control's Effect on Menopause Symptoms
You may be taking birth control pills to prevent pregnancy. But did you know that the pill may also be masking signs of menopause?
By Kristen Stewart
Medically Reviewed by Lindsey Marcellin, MD, MPH
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Most of us associate birth control pills with preventing pregnancy. While that’s certainly true, it turns out that the pill may also minimize symptoms associated with approaching menopause. In fact, your doctor might suggest them to help if your periods go haywire. On the other hand, if you’ve been on birth control pills to prevent pregnancy, the changes they cause may actually keep you from noticing early signs of menopause.
Signs of menopause can occur up to several years before a woman’s final period, a transition time known as perimenopause. You don’t technically enter menopause until a full year has passed without a period. These years can seem like an eternity if you have severe menopause symptoms, such as hot flashes. Menopause symptoms vary from woman to woman, but in general they also include changes in your period. Your menstrual flow could be lighter or heavier and more frequent or farther apart during the perimenopause years. Both hot flashes and irregular periods may be helped with birth control pills.
Given that a woman can become pregnant up until her last period has occurred, women in perimenopause who do not want any more children must consider their birth control options. Many choose birth control pills, most of which contain a combination of the hormones estrogen and progestin. How will these synthetic hormones affect diagnosing menopause?
“Birth control pills (also known as oral contraceptive pills) mask many of the signs of menopause,” says Barbara DePree, MD, director of Women’s Midlife Health Services at Holland Hospital in Holland, Mich. “They work by suppressing the ovarian function; therefore, there is no significant output of estrogen or progesterone from the ovary while on the pill. Instead, oral contraceptive pills add back a fixed amount of synthetic estrogen and progestin daily while the ovary sits by idly.”
This means that while birth control pills can relieve many of the unpleasant side effects of menopause, they can also mask the fact that a woman has undergone “the change” and make diagnosing menopause more difficult.
“Birth control pills do not specifically affect the timing of menopause,” says Robert Tomaro, Jr., MD, a physician in the department of obstetrics-gynecology at Jersey Shore University Medical Center in Neptune, N.J. and immediate past president of the Monmouth County Medical Society. In other words, a woman’s body is designed to reach menopause at a certain age regardless of whether she is taking birth control pills. The pill simply camouflages its pending arrival.
Is It Menopause or the Pill?
Ultimately the main way for a woman using birth control pills to know if she has reached menopause is to stop taking the medication and see what happens. If she is of menopausal age — on average, menopause occurs at age 51 — and does not have a period for a year, then it’s probably safe to say she has been through menopause. For a faster determination of whether or not menopause has occurred, doctors can draw blood and measure the amount of FSH (follicle-stimulating hormone).
Related: Choosing a Birth Control Pill
Keep in mind that birth control pills do carry their own risks, including the possibility of high blood pressure, blood clots, heart attacks, and strokes with the dangers increasing with age and especially in women who smoke.“Most women are good candidates for oral contraceptive pills in perimenopause,” says Dr. DePree. “However, a careful health history should be taken to look for contraindications to birth control pill use — and there are absolute and relative contraindications that are too extensive and complicated to just make a simple list.”
Bottom line: As with all medications, always talk to your doctor to make the right choice for your particular situation.
Video: Women's Health : Long-Term Birth Control Side Effects
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