Medically reviewed by Sophia Yen, MD, MPH – Written by Pandia Health Editorial Team

Menopause and Birth Control: When Is It Time to Quit?

Menopause can be a distressing, confusing time for many women. It’s a natural part of life, and there is no way to know when it will start and exactly when it will end because every woman is different. So when is menopause really over, and when is it safe to quit taking birth control pills? And, can birth control pills help or worsen menopause symptoms? The following article will explore how birth control and menopause interact and when it’s safe to quit taking birth control pills to prevent pregnancy.

What is the difference between menopause and perimenopause?

Perimenopause is the beginning stages of menopause. Perimenopause is the time when women’s reproductive hormones first start to change. Women continue to have periods during perimenopause, but they start to become irregular. In contrast, menopause is the final period a woman has. If a woman has gone 12 months without a period, she has gone through menopause. Her life after that 12 months is considered postmenopausal.

Menopause and Birth Control

When does perimenopause usually start and how long can it typically last?

Every single woman is different. But the average length of perimenopause is four years. The average age of onset for perimenopause is the mid-forties. But some women can experience perimenopausal symptoms as early as the late 30s, or as late as the early 50s. In rarer cases, perimenopause symptoms can last for up to ten years.

What are the symptoms of perimenopause?

Perimenopause can cause many different symptoms that are both disruptive, distressing, and sometimes painful. Symptoms can include the following:

  • Hot flashes and night sweats
  • Breakthrough bleeding and spotting
  • Irregular periods
  • Headaches and migraines
  • Mood swings
  • Trouble sleeping
  • Urine urgency and urine leakage
  • Vaginal dryness
  • Mood swings
  • Acne
  • Fatigue
  • Breast tenderness
  • Lower sex drive
  • Heavier, more painful periods

Sometimes, the symptoms of perimenopause can cause significant problems in day-to-day functioning. Fortunately, women can find relief from these symptoms with hormone replacement therapies and hormonal birth control.

When should a woman see her doctor about perimenopausal symptoms?

It’s common for women to have irregular periods during the perimenopausal stage. However, other more serious conditions can mimic the symptoms of perimenopause. It’s important for women to speak to their doctor to rule out more serious conditions. Hormonal issues, fibroids, pregnancy, blood clotting disorders, and even cancer can cause some of the symptoms usually associated with perimenopause. The following symptoms may warrant a trip to the doctor for testing:

  • Very heavy periods with blood clots.
  • Periods that last much longer than usual.
  • Breakthrough bleeding between periods.
  • Spotting after intercourse.
  • Periods that are happening closer together than normal.

Can women get pregnant even if they’re perimenopausal?

Despite declines in fertility during perimenopause, it’s possible to still become pregnant. To prevent pregnancy, women should continue to use birth control until they reach menopause. If preventing pregnancy is the goal, women should not stop using birth control until they have gone twelve months without a period.

How does birth control affect perimenopause symptoms and menopause?

Birth control pills can help to regulate periods and also reduce pain and bleeding. Birth control pills also help to level out hormones, keeping them from fluctuating to the point of triggering worse perimenopause symptoms. Going through menopause can also cause issues with bone health and bone density. Taking oral contraceptives while perimenopausal can decrease these risks. Once menopause happens, women can stop taking birth control pills.

Some women will find relief from the hot flashes commonly associated with perimenopause after taking low-dose birth control pills. Birth control patches, the vaginal ring, and progesterone injections can also alleviate uncomfortable symptoms.

It is important to note, however, that hormonal contraceptives can mask perimenopause symptoms. Women who’ve been taking hormonal birth control can sometimes not know when they’ve reached the perimenopause stage. Women who continue to take hormonal birth control can continue to go through monthly cycles even after they’ve reached menopause.

When should women not take birth control pills for perimenopause?

Women with a history of blood clots, either personal medical history or family medical history, should stop taking hormonal contraceptives as they enter their late forties. Women who smoke, have heart disease, or a history of cancer should also avoid taking oral contraceptives as they age. Hormonal contraceptives can increase the risk of blood clots in older women with risk factors for these disorders and in women who smoke.

Since hormonal birth control can mask the symptoms of perimenopause, sometimes it’s important to mitigate the risk of blood clots by coming off hormonal birth control regardless of whether or not a woman has experienced perimenopausal symptoms if she has these risk factors.

High-doses of estrogen in many oral contraceptives can increase the risk of blood clots. Instead of using high-dose hormonal birth control to alleviate the symptoms of perimenopause, women can try hormone therapies instead or low-dose birth control pills. To prevent pregnancy, non-hormonal birth control options can also be used during this stage of life.

Low dose birth control pills have 20 mcg of estrogen. Very low dose contain 10 mcg of estrogen. Regular birth control pills have around 30 to 50 micrograms of estrogen. For women 45-49 years old, an endocrinologist from Mt. Sinai New York recommends 20 mcg and changing to 10 mcg for those 50 and older.

How can I tell if I’ve reached menopause?

If a person is on birth control, there is no way to know for sure if they have reached menopause. Someone who is taking the pill may still have “periods” which are actually withdrawal bleeds because of the hormones in the medication.

The average age of menopause is around 51 years old. Some doctors recommend that a person stops taking the pill around this age to see if they have reached menopause yet.

However, someone stopping the pill at this age should still use contraceptive during sex until menopause is confirmed.

How can perimenopausal women benefit from low-dose estrogen birth control?

Not only can low-dose estrogen contraceptives prevent pregnancy, but they can also alleviate uncomfortable and disruptive perimenopause symptoms. In addition, low-dose estrogen pill help to regulate periods, prevent heavy periods and also protect against bone density loss. Without this protection, women are at increased risk of osteoporosis as they age. Another potential benefit of using birth control pills is the prevention of ovarian and uterine cancer.

For women going through perimenopause, they do not have to live with distressing and uncomfortable symptoms. Accessing safe, low-dose hormonal contraceptives is now easier than ever before with companies like Pandia Health. Contact Pandia Health today to have birth control conveniently delivered straight to your door.


The views expressed in this article intend to inform and induce conversation. They are the views of the author and do not necessarily represent the views of Pandia Health, and are for informational purposes only, even if and to the extent that this article features the advice of physicians and medical practitioners. This article is not, nor is it intended to be, a substitute for professional medical advice, diagnosis or treatment, and should never be relied upon for specific medical advice.