Medically reviewed by Sophia Yen, MD, MPH and Catherine Hansen, MD, OBGYN & Menopause specialist

Research shows that while menopause is a fact of life, few women feel informed on the subject. Over 68% only begin learning about perimenopause once symptoms first develop, causing many to go through this important life stage without the necessary knowledge and medical care. Consequently, many perimenopausal women suffer in silence, which is unnecessary — especially when there are safe, practical solutions to help curb the severity of symptoms. Birth control for perimenopause is one such remedy.

As a telemedicine service specializing in hormonal women’s care, we understand the unique challenges that women face during perimenopause. Our goal is to provide you with comprehensive information on birth control methods tailored specifically to address the symptoms and concerns associated with this transitional phase of life. Let’s dive into it!

A photo of a package of birth control pills

What Is Perimenopause?

Perimenopause is a natural phase that occurs before menopause, typically starting in a woman’s 40s and lasting between four and eight years. During this time, the hormone levels in the body start to fluctuate as the body starts to transition away from the reproductive stage of life. This variation in hormone levels can lead to some uncomfortable symptoms like missed or more abundant periods, hot flashes, mood swings, and night sweats.

Hormonal birth control can be a valuable tool in managing these symptoms and improving the overall quality of life for women going through perimenopause while protecting them from unwanted pregnancy. This is crucial to understand because as long as a woman has not reached menopause, pregnancy remains a possibility after unprotected intercourse with a male.

You may be wondering how birth control pills can help with perimenopause symptoms. No worries, we’ve got you! Combined oral contraceptive pills blend two hormones, progesterone and estrogen, and they provide the body a steady level of hormones throughout the month. By doing this, birth control pills can smooth out the body’s natural fluctuations experienced during perimenopause and balance your body’s hormones. A balanced level of hormones will help reduce hot flashes, night sweats, ease mood swings, reduce the flow of your periods, as well as regulate periods among others.

As of 2020, nearly 50% of women worldwide were unaware of perimenopause and were surprised when it started. This can be overwhelming, but if you’re among these women, you’re not alone.

What are the symptoms of perimenopause?

The average age for women to enter menopause is 51 years old. However, the physical changes associated with perimenopause can begin years before your final menstrual period. While the average duration of perimenopause is three to four years, some women experience physical and emotional changes for only a few months. Others go through perimenopause for as long as a decade.

Because each woman’s experience differs, you can’t compare your symptoms to a friend’s symptoms. Some women don’t experience any symptoms besides irregular periods. Others seek support to reduce the severity of hot flashes, night sweats, and vaginal dryness/discomfort/pain during intercourse. These changes are because of low or no estrogen.

Some of the most common symptoms include:

  • Sleep disturbances
  • Mood symptoms (i.e., increased depression and anxiety)
  • Irregular period bleeding (more, fewer, heavier, lighter)
  • Vaginal dryness
  • Hot flashes and night sweats
  • Decreased sex drive
  • Bladder infections
  • Leaking urine, peeing more frequently

Some women may also experience trouble focusing or concentrating and suffer short-term memory issues, which may cause them to seek treatment.

These symptoms can last months to years.

Find out if it might be perimenopause or menopause quiz. Woman using hand fan

Should You Take Birth Control During Perimenopause?

Treating symptoms of perimenopause with birth control may seem like an odd remedy. However, hormonal birth control is not exclusively used for contraception. The hormones released from birth control pills can treat acne, PCOS (polycystic ovarian syndrome), and more including perimenopause — but is it right for you?

Because no two women’s experiences are identical, discussing the next steps with a healthcare provider is valuable. Although the hormones in birth control are safe for most women, the risks differ depending on several variables. For example, pre-existing conditions and heavy smoking can increase risks of blood clots, stroke, and even death.

Birth Control Options for Perimenopause Symptoms

So, what types of birth control for perimenopause are available? Each option has advantages and disadvantages, and some are better suited for some women than others. Knowing what’s available helps you: weigh your options better and ask your healthcare team more specific questions based on your concerns and current health status.

Birth control pills

Taking birth control pills for perimenopause can help you reduce your hormone fluctuations. However, there are 40+ different formulations of birth control pills, so it’s useful that you use a Pandia Health doctor to find out which type of birth control pill is best for your unique needs.


Hormonal patches are another form of hormonal birth control that can be used during perimenopause. These patches contain estrogen and progestin, which are absorbed through the skin to regulate hormone levels. The patches are typically applied once a week for 3 weeks, resting on the fourth week when a withdrawal bleed will take place. They can be a convenient option for women who prefer not to take daily pills.

Vaginal Ring

These are flexible rings that are inserted into the vagina and release hormones to prevent pregnancy. They work by continuously releasing estrogen and progestin to regulate hormone levels. Vaginal rings are typically inserted and left in place for three weeks before being removed for a week to allow for a withdrawal bleed. They offer a discreet and low-maintenance birth control option for perimenopausal women.

Get Birth Control for Perimenopause Symptoms

The board-certified doctors at Pandia Health can prescribe birth control for perimenopause right from the comfort of your own home. Best of all, we free ship your prescription straight to your door every month.

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Hormonal intrauterine device (IUD)

Another option is a hormonal IUD, ideal for women experiencing heavy bleeding during perimenopause. Hormonal IUDs contain a synthetic progesterone that helps lessen bleeding but will not treat other perimenopausal symptoms associated with decreasing estrogen (such as hot flashes, night sweats, insomnia or dry vagina). However, this hormonal IUD can be used alongside estrogen therapy which will help relieve symptoms such as hot flashes and sleeping issues.

However, there are some potential side effects, and because IUDs can stop women from getting a monthly bleed (aka period), it can be tough to tell if you’ve entered menopause. But there are other ways to check.

Best Contraceptive Pill for Perimenopause

Pandia Health’s team of expert doctors, Menopause Society Certified Practitioners (MSCPs), recommend using low dose birth control for perimenopausal women. Low dose birth control pills have less estrogen than the other birth control pills which typically have 35 to 50 micrograms. Back in the day, birth control pills could have 50 to 110 micrograms of estrogen! That being said, low hormone birth control pills nowadays are those that have 20 to 30 micrograms of estrogen and these are safer for women who are perimenopausal. Examples of low dose pills are Enskyce, Reclipsen, Ocella, Zumandimine, Yaz, or Yasmin among others.

Apart from the pill, another low dose birth control option is the Nuvaring that contains 15 micrograms of estrogen and is worn for 3 consecutive weeks before it is removed to allow a withdrawal bleed to occur.

If you are experiencing perimenopause symptoms, a low dose birth control pill can be a good fit for you! It’s important to consult a professional doctor to find the safest birth control for your unique needs. At Pandia Health we have expert doctors that can prescribe you the pill that best suits your needs and health history from the comfort of wherever you have a device and internet. Plus we offer FREE delivery for all your refills! However, if you are experiencing serious symptoms such as very heavy or abnormal bleeding we encourage you to see a doctor in person for a full evaluation.

Choosing the Right Birth Control for Perimenopause Symptoms

The right birth control for perimenopause depends on what makes the most sense for your unique needs and preferences. Consider the following.

Do you have pre-existing health conditions?

Estrogen-containing contraceptives are not recommended if you have a history of: estrogen-dependent cancer, blood clots, heart disease, etc. While most potential interactions involve physical symptoms, your doctor must also be mindful of pre-existing mental health issues. For example, if you have depression, understanding the link between hormonal contraception and mood disorders is vital when choosing the right pill for you. Progestogen-only contraceptives should be used with caution if you have a history of depression.

Do you smoke?

If you smoke, consult a doctor about your options. Taking birth control while smoking can increase the risk of cardiovascular issues like strokes and heart attacks. If you are over 35, smoke, and want to start taking birth control or change your birth control method, you must consult with a doctor because many estrogen-containing contraceptives, including birth control pills, are contraindicated for smokers over 35 years of age

What are your specific symptoms?

For instance, are you experiencing a flareup of acne because of perimenopause? Do you want to reduce hot flashes? If these symptoms are present, oral hormonal contraceptives may be an excellent option. Another reason many perimenopausal women choose to go on birth control pills is that this medication may help reduce vaginal dryness and prevent bone loss.

Get Personalized Birth Control Advice From Our Expert Doctors

Ready to start treating your perimenopause symptoms with birth control? Pandia's board-certified doctors offer personalized prescription to fit your needs. 

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When it comes to birth control options for perimenopause, there are several choices available to suit individual preferences and needs. From birth control pills and vaginal rings to hormonal IUDs and non-hormonal barrier methods, women have a range of options to consider when wanting to avoid pregnancy during perimenopause.

However, to ease perimenopausal symptoms, hormonal birth control (usually a low dose combined contraceptive pill) is the best option as it provides hormonal symptom relief AND regulates irregular perimenopausal bleeding until Menopausal Hormone Therapy (MHT) becomes a better fit (after menopause proper).

Before getting started on birth control or switching your current birth control, it is important to talk to a doctor to determine the most appropriate birth control method based on individual medical history and preferences. Our accredited menopause experts will prescribe FDA-approved medications that are extremely safe and effective for treating perimenopause symptoms. Hormonal care should be as unique and individualized as every woman it supports.

Sign up today to get an online consultation and get your prescription today! We offer FREE delivery service for all your refills. Start managing symptoms of perimenopause now with Pandia Health expert doctors!

Pandia Health is dedicated to providing accurate, reliable women’s health knowledge. Connect with Pandia Health on TikTok, Youtube, Instagram, and Facebook to get expert insights on birth control, women’s health, and menopause.

Disclaimer: This article is for general informational purposes and is NOT a substitute for professional medical advice. Always seek the advice of your healthcare provider before starting or changing birth control.