Medically reviewed by Sophia Yen, MD, MPH – Written by Pandia Health Editorial Team. Updated on March 1, 2021

Menopause can be a distressing, confusing time for many women. It’s a natural part of life, but the timeline may vary between individuals with a uterus. You may have several questions about what this process entails, which is totally normal! The following article will provide some insight, particularly in terms of how to manage birth control use as you approach menopause.

women when to stop birth control

What is menopause? 

The National Institute of Health (NIH) defines menopause as “a point in time 12 months after a woman’s last period.” This is commonly experienced between the ages of 45 and 55 and can last anywhere from seven to 14 years. During this time, the body’s production of estrogen and progesterone (a.k.a the female hormones) decreases.

Menopause is often incorrectly used interchangeably with “perimenopause,” which refers to the early stages of the menopausal process. However, a person with a uterus has only officially reached menopause one year after their last period.

What is the difference between menopause and perimenopause?

Perimenopause is the time when the reproductive hormones first start to change. While periods continue during this time, they typically become irregular (i.e. a period may not occur every month) as the production of estrogen and progesterone slows down. Additional symptoms may occur, though some individuals report feeling normal during perimenopause. With that said, it is always a best practice to consult with a doctor if you notice any abnormal changes in your body.

In contrast, menopause is marked by the final period a woman has. If a person with a uterus has gone 12 months without a period they have gone through menopause. Their life after that 12 months is considered postmenopausal.

Menopause and Birth Control

How long does perimenopause last?

The average length of perimenopause is four years. With that said, it may only last a few months for some or up to 10 years for others, though this is rare. An individual can know that they have completed perimenopause once they have gone 12 months without getting a period.

What are the symptoms of perimenopause?

Although menopause is a normal, healthy part of life for individuals with a uterus, it typically entails symptoms that can become unpleasant. Some individuals may not notice any significant changes, but many will likely experience one or more of the following:

  • Hot flashes and night sweats = a sudden feeling of warmth that spreads over the body
  • Breakthrough bleeding and spotting = bleeding when not on your period 
  • Irregular periods = inconsistent timing and heaviness of periods 
  • Headaches and/or migraines = pain that occurs in one or more regions of your head
  • Mood swings = intense and sudden changes in mood 
  • Insomnia = persistent difficulty falling or staying asleep 
  • Urine urgency and/or leakage = constantly feeling the need to go pee 
  • Vaginal dryness = lack of lubrication in the vagina 
  • Acne = blemishes (i.e. white heads and black heads) that pop up on the skin
  • Fatigue = feeling more tired than usual 
  • Breast tenderness = sore and/or swollen breasts 
  • Lower sex drive = lack of desire to have sex and/or pain during sex

Sometimes, the symptoms of perimenopause can cause significant problems in day-to-day functioning. Fortunately, there are various treatments that can be implemented to help provide some relief.

doctor talking to patient

When should you see a doctor about perimenopausal symptoms?

While experiencing some symptoms is normal and common, a person with a uterus should consult a doctor if their daily life is negatively impacted. It is possible that their experience is solely related to perimenopause, but it could also be the result of other, more serious conditions such as fibroids, pregnancy, blood clotting disorders, or even cancer. Furthermore, speaking with a doctor is necessary in order to ensure that symptoms are caused by menopause and not something else.

The following symptoms may warrant a trip to the doctor

  • Very heavy periods with blood clots.
  • Periods that last much longer than usual.
  • Periods that occur more frequently than normal
  • Breakthrough bleeding between periods.
  • Spotting and/or pain after intercourse.

Can women get pregnant even if they’re perimenopausal?

Tldr: yes! 

Despite declines in fertility during perimenopause,  it is still possible to become pregnant. Even when periods become less frequent, the body may be releasing more eggs. Furthermore, if a person with a uterus is currently taking birth control, they should continue to do so during perimenopause. If they are not on birth control, they should use an additional form of contraception (i.e. condoms) for protection. It is also necessary to keep track of menstrual cycles in order to determine when it has been 12 months since the last cycle. Scheduling regular gynecological visits is a great way to help ensure that any rogue pregnancies will be detected early.

How does birth control affect perimenopause symptoms?

Hormonal birth control (i.e. the pill, patch, ring, IUD, etc.) can help prevent pregnancy and eliminate period symptoms. Similarly, using birth control during perimenopause can help alleviate unpleasant symptoms and even decrease the likelihood of negative health conditions. For instance, the process of menopause may lead to osteoporosis and other bone-related issues, and implementing birth control can help reduce this risk. Additionally, because birth control regulates hormone levels, it can further minimize some of the effects associated with perimenopause such as hot flashes, acne, and vaginal dryness.

It is important to note, however, that hormonal contraceptives can mask perimenopause symptoms. Furthermore, those who take birth control may not recognize when they have reached the perimenopause stage. For this reason, it is crucial to communicate with a doctor in order to better understand what is going on in your body.

When should women not take birth control pills for perimenopause?

While hormonal birth control can be extremely beneficial, it can increase the risk of blood clots in some individuals with a uterus. More specifically, it is recommended that those with a history of blood disorders, heart disease, and/or cancer (either in their family or personally) stop taking hormonal contraceptives as they enter their late forties. This also applies to individuals who smoke.

Instead of using high-dose hormonal birth control (which can increase the likelihood of developing blood clots) to alleviate the symptoms of perimenopause, individuals with a uterus can try hormone therapies or low-dose birth control pills. With that said, there are pros and cons to these methods, so individuals should consult a doctor in order to determine the best path for their lifestyle.

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

Low-dose birth control can be implemented both to prevent pregnancy and alleviate symptoms of perimenopause. Although low dose birth control is typically not recommended for individuals under the age of 30 because it can decrease bone density, it may have the opposite effect for those going through perimenopause. This is especially important, as the risk of osteoporosis increases with age. Low dose birth control may also be implemented to help prevent ovarian and uterine cancers.

How can I tell if I’ve reached menopause?

The average age of menopause is around 51 years old. Once an individual with a uterus has gone 12 months without a period, they have reached menopause. However, this may be difficult to track if the individual is taking hormonal birth control. Some may choose to stop birth control once they start to notice symptoms of perimenopause for this reason, but this does not have to be the case for all individuals. If one does choose to stop taking birth control, they should use another form of contraception (i.e. condoms) to prevent pregnancy. 

What’s the takeaway?

While menopause may seem like a scary thing to tackle, it is a natural part of life that occurs in all women with a uterus. Thankfully, several methods can be implemented to make the process a little easier. So rather than feeling doomed or ashamed if you are approaching the age of menopause, you might as well embrace it! 

With Pandia Health, you can #SkipTheTrip to the pharmacy and feel confident that you will never run out of birth control on our watch. 

Frequently Asked Questions 

Can birth control cause hot flashes?

While birth control is typically not associated with hot flashes, if you do notice temperature fluctuations after starting a new prescription, consult a doctor to determine whether it may be a good idea to switch. Low-dose birth control may actually be implemented for those going through perimenopause as a means to reduce the severity of hot flashes.

Do birth control pills delay menopause?

Birth control pills have not been found to delay menopause.

Do I need birth control after 45?

This depends on whether or not you have reached menopause. If you are still in the perimenopause stage, you can keep taking birth control in order to prevent pregnancy and reduce symptoms.

Can birth control cause night sweats?

Night sweats may occur as a result of starting a new birth control prescription. However, this will not be the case for everyone.

Does birth control help regulate periods?

Yes! Birth control stabilizes the female hormones, estrogen and progesterone, in order to create more regular cycles. It is also possible to skip your period while on birth control by skipping the row of sugar pills.

Can perimenopause mimic pregnancy symptoms?

Perimenopause symptoms such as nausea, weight gain, and hot flashes can mimic those associated with pregnancy. With that said, it is important to take note of what is going on in your body and consult a doctor if you notice any changes.

What age should you stop taking birth control pills?

This can vary depending on when an individual wants to get pregnant and/or starts to experience perimenopause symptoms. Consult a doctor if you are considering stopping your current birth control.

How long does perimenopause last?

Perimenopuse typically lasts anywhere between a few months and four years.

Can periods restart after menopause?

Periods do not restart after menopause. If you do experience vaginal bleeding after you have gone through menopause, consult a doctor.

How long is too long for a period during perimenopause?

While this may vary in each individual with a uterus, most periods that occur during perimenopause should not last more than seven days.

How long does a woman go through menopause?

The entire process of menopause (perimenopause, menopause, and post-menopause) typically lasts between 7 and 11 years, though it may be more or less for some.

Disclaimer: 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.