Most of us hit 40 feeling great: our confidence is high, we’re at the peak of our careers, we’re finally comfortable in our own skins.
And then: perimenopause. With its hot flashes, dry skin and hair, irregular periods, memory lapses, and general irritability, it can be a confidence killer. Just when we finally had it all figured out.
But what if there were a way to avoid losing your momentum?
Perimenopause is that 2-10 year period before our periods cease altogether. It’s a time of fluctuating hormone levels, when estrogen, progesterone, and testosterone are up and down like five-year-olds at bedtime. Erratic and dropping estrogen is the primary culprit behind many perimenopause symptoms and can start affecting a woman as early as her mid-30s.
One way to manage many perimenopausal symptoms may be a medication you thought you were done with: the Pill.*
Hormonal birth control provides synthetic estrogen and progestin, keeping them at a stable level for a woman’s cycle. This prevents the estrogen rise mid-cycle that triggers ovulation.
The Pluses: Because it flattens the hormonal rises and declines that cause many perimenopause symptoms, hormonal birth control can reduce hot flashes, ease mood swings, lessen the menstrual flow, regulate erratic periods, and lessen the impact of endometriosis.
According to Harvard Health, birth control pills may reduce vaginal dryness and prevent bone loss, all while protecting you from endometrial, and ovarian, and colorectal cancers.
Because the dosage is set so low (35 micrograms of estrogen or less), and because current formulations of the Pill are safer than previous versions, there are fewer side effects and risks to fear. Studies show low-dose birth control doesn’t cause weight gain, and vascular issues like deep-vein thrombosis and stroke aren’t generally an issue for women over 35 who don’t smoke.
The Minuses: The risk of increased breast cancer is still a subject of some debate, particularly when it involves women who are older (possibly because they started with the higher-dose oral contraceptives that were available when they were younger) or who have a family history of breast cancer.
Migraines may worsen with hormonal birth control, and the possibility of blood clots does still exist for some. Pills containing estrogen are not advised for those at risk of cardiovascular disease or hypertension or for those who smoke.
Finally, the Pill does not protect against sexually transmitted diseases such as herpes, gonorrhea, genital warts, or HIV.
Because hormonal birth control can mask menopause symptoms – including causing “withdrawal bleeds” during the sugar-pill week – a woman on mixed-hormone oral contraception may not know when or if she’s completed the transition to menopause. Getting an FSH (follicle-stimulating hormone) test during the 7-day “off” period may indicate if a woman is in menopause. At that point, some research indicates, a woman can transition from oral contraceptives to HRT (hormone replacement therapy), if she decides to go that route.
There are natural ways to manage menopause symptoms that are highly effective for some women. There are lifestyle choices that can make life during this challenging time easier for others. And for some women, there are low-dose birth control pills. There are risks to oral contraceptives, higher for some women than others, so please – do your research, talk to your doctor, make sure the information you’re getting is recent and reliable.
*The information in this blog is for educational purposes only. To understand your potential risks and benefits, talk to your doctor.