Women going through the transitional phase of perimenopause may need help dealing with the body’s reaction to the slightly decreased levels of the ovarian hormone estrogen.
Oral contraceptives are increasingly being considered to fulfill this role.
Even though the use of oral contraceptives in this way has not been approved by the FDA (US Food and Drug Administration), it has been scientifically proven that these contraceptives also offer several additional health benefits beyond birth control for the perimenopausal woman.
However, just as when used in earlier years of a woman’s life, oral contraception does carry some risks.
Be sure to consult a doctor when considering this option for treatment of any perimenopausal symptoms.
Starting Oral Contraceptives for Perimenopause
Unlike regular hormone replacement therapy, there are no well-defined criteria for when a woman can start using oral contraceptives to treat perimenopausal symptoms.
If a woman suspects that she has symptoms due to perimenopause that bother her enough to need medication, she can really start whenever she wants. All she needs to do is see her doctor to make sure none of the contraindications apply to her.
Benefits of Oral Contraceptives for Perimenopause
In addition to protecting a woman against unwanted pregnancy, oral contraceptives are also very effective at relieving the annoying symptoms that may be brought about by perimenopause. Some of these symptoms that can be relieved are:
• Pre-menstrual syndrome: PMS can sometimes get worse with the onset of perimenopause.
• Menstrual cycle irregularity: perimenopausal women will often start to experience an erratic menstrual cycle.
• Growing menopausal symptoms: oral contraceptives may relieve minor hot flashes, irritability, insomnia, and any other symptoms common to the beginnings of menopause.
Side-Benefits of Oral Contraceptives While the main goal of using birth control pills for perimenopausal women is to get rid of certain perimenopausal symptoms, women using these pills can also get some other important health benefits.
Some of them are:
• A small decrease in bone loss: estrogen prevents the reabsorption of bone while stimulating the release of calcitonin, which maintains bone mass.
Therefore, a decline in estrogen levels due to perimenopause results in bone loss, which can lead to osteoporosis and fractures.
Supplementing a woman's body with small extra doses of estrogen can thus slow this harmful process.
The best dose to use is 25-35 micrograms of ethinyl estradiol combined with the progestin norethindrone (click here for a list of birth control pills that fit this criteria).
• Management of fibroids: some perimenopausal women will develop leiomyomas (tumors made up of smooth muscle tissue) in their uterus. Oral contraceptives may be useful for treatment of these tumors (also called fibroids).
Who is Not Eligible
The contraindications listed for use of oral contraceptives in women past age 35 are:
• History of thromboembolism (a condition that involves blood vessel clots)
• Estrogen-dependant abnormal tissue growth (tumor or cancer)
• Undiagnosed atypical genital bleeding (vaginal bleeding)
• Cholestatic jaundice (jaundice that is caused by blockage of the outlet of the gallbladder)