How Does Taking Birth Control Pills Affect Menopause?

During childbearing years, many individuals take hormonal birth control pills. As you near the age where menopause can occur, you might be asking: can you go through menopause while on the pill?

The short answer is yes, you can go through menopause, but being on the pill can mask some of the symptoms.

This article will discuss birth control and menopause, including how it can affect symptoms, how to know when you've reached menopause, and when to stop taking the pill.

How Do Birth Control Pills Affect Menopause Symptoms?

First, let's cover some terminology about menopause:

• Perimenopause is when periods begin to change, often becoming less frequent. Perimenopause lasts about four years and ends with your last period. During perimenopause, you may have periods more or less often than you usually do. You may also skip periods and start experiencing menopause symptoms such as hot flashes.
• You have gone through menopause when you have not had a menstrual period in 12 consecutive months. The average age of menopause is 51 years, but the general age range is from 45 to 55 and can range from 40 to 60 years.
• Postmenopause is the time after menopause has occurred.

Taking birth control pills can mask some of the symptoms of perimenopause, such as the irregular periods mentioned above and other symptoms. Because of this, it can be difficult to know if you are having side effects due to the birth control pills or experiencing changes as a result of approaching menopause.

Does the Type of Pill Matter?

Birth control pills are generally grouped into two categories:

• Combination birth control pills contain both an estrogen and a progestin hormone
• Progestin-only pills ("minipills") contain progestin only, and do not contain estrogen

Both types of birth control pills can result in changes in bleeding, which could entail shorter or longer cycles, spotting, irregular periods, or lighter periods.

In rare cases, some people experience heavier periods, but many have lighter periods, while some have no periods at all. Therefore, either type of birth control pill can have side effects of irregular bleeding that can mask bleeding changes associated with menopause.

Birth Control Pill Side Effects vs. Menopause Symptoms

Side effects of birth control can overlap with menopause symptoms. They have some similar symptoms (such as changes in bleeding, vaginal problems, and weight changes) as well as unique symptoms.

The table below compares the common issues of both. If you are taking birth control but think you may be in perimenopause, it's a good idea to consult your healthcare provider.

How Do I Know If I'm Approaching Menopause?

When you are in perimenopause, you may or may not have symptoms, and symptoms can vary in intensity from very mild to severe. Some symptoms you may experience in your 40s or 50s include:

• Hot flashes: Feeling suddenly hot in the upper body and face, lasting seconds to minutes or longer. Hot flashes that happen at night are called night sweats, and they may interfere with sleep, causing you to feel tired during the day.
• Trouble sleeping: You may have trouble falling asleep and/or staying asleep, or you may have interrupted sleep because of night sweats.
• Vaginal changes: Due to reduced estrogen levels, the vaginal lining can become thinner, dryer, and less elastic. The dryness may cause painful intercourse, and you may experience more vaginal infections. Urinary tract infections can occur, too, as a result of the urethra becoming dry and irritated.

If you have any questions about perimenopause or menopause, you can consult your healthcare provider for medical guidance.

Have I Reached Menopause?

You reach menopause when you have not had any bleeding, including spotting, for 12 months in a row. This means your periods have permanently stopped, and you cannot get pregnant.

Taking birth control pills can make things more complicated, especially for those who completely stop bleeding as a side effect of birth control pills. In this case, you can consult a healthcare provider for medical guidance.

Experts note that hormonal testing is not a definite diagnosis of menopause; however, taking into account specific labs with age can help healthcare providers assess menopause status in people over 50 who take hormonal birth control.

Researchers suggest one way to test for menopause in people who take birth control pills is to stop taking it for two or three months at age 50, and see if menstruation occurs.

During this pill-free time, the healthcare provider can check lab tests at regular intervals and ask about symptoms. Note that you will need a backup method of birth control, such as condoms, if you stop taking birth control pills before you have reached menopause and do not wish to become pregnant.

Keep in mind that the labs often tested, called follicle-stimulating hormone (FSH) levels, may not be accurate on their own, which is why healthcare providers consider multiple variables.

When to Stop Taking the Pill

If you are taking the birth control pill, you should always check with your healthcare provider before stopping the pill. Stopping the pill too soon could result in an unintended pregnancy.

Fertility decreases during perimenopause, but you can still get pregnant until you have reached menopause, which is 12 consecutive months without a period. Even if you have gone 10 months without a period, you can still become pregnant. Experts recommend using a safe, effective, and appropriate type of birth control until menopause is confirmed.

Taking birth control pills can also provide additional benefits besides preventing pregnancy, such as:

• More regular cycles
• Less bleeding (and less chance of iron deficiency anemia)
• Less intense menstrual cramps
• Lower risk of ovarian cancer
• Lower risk of endometrial cancer
• Lower risk of colorectal cancer
• Fewer hot flashes and other menopause symptoms
• Improved bone strength
• Improved acne, which may flare during menopause

However, some risks may increase, such as a higher risk of blood clots, and potentially increased risk of heart attack, stroke, and breast cancer.

If you are perimenopausal, you should not take birth control pills that contain estrogen (you can take a progestin-only pill if approved by your healthcare provider) if you:

• Smoke
• Have a history of estrogen-dependent cancer
• Have heart disease
• Have high blood pressure
• Have diabetes
• Have or have had blood clots

If you wish to stop taking the pill but still need birth control, there are many options, such as:

• Injections
• Skin patches
• Vaginal rings
• Implants
• Hormonal or copper intrauterine devices (IUDs)
• Barrier methods such as condoms (both external and internal condoms)
• Permanent birth control, including vasectomy for males or tubal ligation for females

You can talk to your healthcare provider about the best form of birth control for you.

Summary

Menopause can cause symptoms like hot flashes, night sweats, mood swings, and vaginal dryness.

For those who take birth control pills, it may be difficult to differentiate the side effects of the pill from symptoms of menopause. This is especially true because it is often difficult to know if menstrual bleeding has stopped due to the birth control pills or menopause.

Consult your healthcare provider for more information and medical advice about your reproductive health and menopause.