How do contraceptive pills affect menopause and its symptoms? A doctor explains!

Many women, including perimenopausal women, use contraceptives to prevent getting pregnant. However, taking the pill can mask some of the symptoms of menopause, making it difficult for a person to tell if they have passed through menopause and stopped menstruating. Hormone therapy might be a better option in some cases. Want to know more about oral contraceptive use during menopause? Doctor Jael Loefstop will explain everything in this article.

What is the effect of the contraceptive pill on menopause?

The menopausal transition is a natural part of life during which the body changes and a woman’s reproductive life gradually ends. Most women reach menopause (their final menstrual period) around the age of 51. About 80 percent of menopausal women report having menopausal symptoms, such as hot flashes, mood swings and sleep problems, during this stage. Most of these symptoms are caused by hormonal changes.  

Contraceptive pills contain of synthetic hormones, usually ethinyl-estradiol (oestrogen) and progestin (progesterone), or a combination of both. These hormones interfere with the body’s natural hormonal balance. By regulating hormone levels, the pill decreases hormone-related symptoms and suppresses the menstrual cycle to eliminate ovulation and prevent pregnancy. When you are on the contraceptive pill, the bleeding you have every month is called ‘withdrawal bleeding’. It is not the same thing as a period because it is caused by hormones. This means you cannot know for sure if you've stopped menstruating and reached menopause when you are on the pill.

To use or not to use the pill

If you are on the pill, or any other form of hormonal contraception, you still have monthly withdrawal bleeds. Withdrawal bleeding is caused by a drop in hormone levels in the body (during the pill-free week). This means you cannot know for sure if your menstrual cycle has changed or stopped when you are on the contraceptive pill. What’s more, taking the pill can mask some of the symptoms of menopause, making it difficult to tell if you have reached it. 

On average, women reach menopause at age 51. Doctors may recommend that you stop taking the pill around this age to see if your natural periods return. According to the guidelines, it is safe for all women to stop contraception at the age of 55.  

Some doctors advise to stop taking the pill sooner and switch to a non-hormonal form of birth control. This is because the risks associated with hormonal contraceptives increase with age. The risks of hormonal contraceptives in women over 50 include: 

• Slightly increased risk of thrombosis 
• Slightly increased risk of high blood pressure 
• Slightly increased risk for heart and vascular disease 
• Slightly increased risk of breast cancer 

Hormone therapy for menopausal symptoms?

Hormone replacement therapy (HRT) replaces the female hormones that are at a lower level as you experience menopause. It is designed to improve symptoms associated with hormone changes, such as hot flashes or sleep problems.  

HRT is not a replacement for birth control but is often used as a first-line therapy in the treatment of menopausal symptoms, because it contains a lower dose of hormones than contraceptive pills.  

There are different types of hormone replacement therapy (HRT) and they can contain different types of oestrogen and progesterone: bioidentical hormones and synthetic hormones. Your current health condition and needs will play a big part in your doctor's consideration of whether HRT, and what kind, is right for you.  

Note: HRT is not a contraceptive. It's still possible to get pregnant while taking HRT, so you'll need to use contraception if you are still menstruating. 

Could hormone therapy be an option for you?

Hormone replacement therapy (HRT) contains hormones, but in lower doses than hormonal contraceptives, and sufficient to reduce menopausal symptoms. Hormonal contraceptives can increase the risk of health issues – especially as you age. Therefore, HRT might be a better option.  

More about hormone therapy

What are options for non-hormonal contraception?

First things first. Do you want to prevent pregnancy and do you still have monthly periods, or has it been less than 12 months since your last period? Then you need to use some form birth control. There is always the chance that you could get pregnant. We have listed the non-hormonal options below. 

• Male condom 
• Female condom 
• Copper IUD 
• Diaphragm (silicon cap) and spermicide gel 
• Sterilisation 
• Temperature method 

How to make an informed decision

During perimenopause, fluctuating or declining levels of oestrogen and progesterone can cause hormones to become unbalanced, leading to symptoms such as menstrual changes, hot flashes and mood swings. Contraceptive pills suppress these symptoms. To make the right decision, you need to consider all the options, because the contraceptive pill is not always the best choice. One option could be hormone replacement therapy (HRT), but there are also non-hormonal options. Some women take supplements like omega-3, magnesium or Solgar® MenoPrimeto manage their symptoms.

The affiliated doctors of SeeMe-nopause are happy to advise you

Whatever option you choose, the main thing is to educate yourself about the available options and any associated risks. This way, you can make an informed decision. Every woman is different, so there is no one-size-fits-all approach. On our platform, you can request hormone replacement therapies and other medications . You will need to complete a medical questionnaire and a doctor will review your order and offer advice to ensure the medication is right for you.  

FAQ

Does taking the contraceptive pill delay menopause?

No, you’ll reach menopause around age 50 whether you're taking birth control pills or not. However, hormonal contraceptives contain synthetic hormones which mimic ‘natural’ menstruation, so it’s possible that you reach menopause (stop menstruating) without being aware of it.  

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