How Hormonal Birth Control Can Help in Perimenopause

Aparna Ramanathan, MD MPH FACOG
Aparna Ramanathan, MD MPH FACOG
Published: April 18, 2022Updated: April 19, 2022
small white pills all in a horizontal lines across rectangle image with baby pink background.

Reviewed by Dr. Lisa Czanko MD, MPH

Do you remember when you had your first period? To understand how hormonal birth control can help people during perimenopause, we have to journey back to a potentially cringe-worthy time: puberty.

For most, puberty is rough. So much is going on all at once and no one really has an answer better than “it will get better.” Your first year of periods was probably unpredictable, your moods swung high and low, and your body suddenly didn’t feel like yours.

Thanks to fluctuating hormone levels, people will often experience something similar in the years leading up to menopause as well. However, the experience, symptoms, and intensity can vary greatly from person to person. 

Hormonal birth control is very important in preventing pregnancy, but their benefits can go far beyond that. Birth control pills can also provide relief from perimenopause symptoms, such as heavy or irregular bleeding with periods. Hormonal birth control can also help symptoms like hot flashes, night sweats, bone loss, vaginal dryness, and more.

In this article, we’ll explore the latest research supporting birth control pills as a management tool for perimenopause symptoms.

How can hormonal birth control help with perimenopause symptoms?

Irregular or heavy periods

During perimenopause, a person’s period can become irregular due to changing hormone levels. This means that periods may happen more or less frequently than once per month and may sometimes be very heavy. Hormonal birth control can help by keeping the body’s hormone patterns more balanced, leading to more regular periods. 

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Hot flashes

One of the most common symptoms of menopause that starts in the perimenopausal period is hot flashes. On average, hot flashes start approximately 2 years before a person will have their last period. During a hot flash, skin temperature rises because blood vessels close to the skin dilate. People may experience the sudden sensation of a wave of heat spreading over the body followed by sweating. Blood pressure and heart rate can also increase with hot flashes. Each hot flash typically lasts between 1 and 5 minutes.  

Scientists don’t clearly know how hot flashes are caused, but believe that there is some dysfunction that occurs in the part of the brain responsible for regulating temperature Estrogen withdrawal or rapid fluctuations in estrogen levels may lead to these changes in the brain. As a result, the estrogen in combined pills can help people with hot flashes. Some people find that the hot flashes come back when taking the placebo pills so taking the pills continuously may better provide relief. 

Painful sex

Hormonal birth control can also improve vaginal dryness and painful sex by increasing the flow of estrogen to your vaginal walls. This means that penetrative sex can be more comfortable.  

Mood changes

Mood changes can be another effect of fluctuating hormone levels during perimenopause. People may experience anxiety, irritability, anger, or depression during this time. Hormonal birth control can help to regulate these hormone fluctuations and help people feel more balanced emotionally.

For those that experience thoughts of suicide, the Suicide Hotline is available 24 hours a day, 7 days a week at 800-273-8255. 911 is also always available. 

hot flashes start approximately 2 years before a person will have their last period.

Is it important to be on contraception during perimenopause?

Yes! If pregnancy is not desired, it is important to continue to use an effective form of birth control throughout perimenopause as it can still be possible to get pregnant during this time. 

In Case You Skimmed

  • Perimenopausal people who use birth control pills to prevent pregnancy may also receive additional benefits like regulation of periods, decreased hot flashes, less vaginal dryness, and more stable moods. Be sure to talk to your doctor before starting on any medications to make sure they are right for you.

Our Simple Note:

We know that changes in the body are never easy, so don’t get discouraged when you start to experience symptoms of perimenopause. These symptoms are totally NORMAL, although not exactly fun to experience. Remember, that medications, including birth control, are great ways to keep perimenopause symptoms at bay. Don’t hesitate to reach out to a medical provider for additional information on what might be best for your individual symptoms.

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ACOG Practice Bulletin No. 110: Noncontraceptive Uses of Hormonal Contraceptives. Obstet Gynecol 2010; 115(1):206-18.

Allen RH, Cwiak CA, Kaunitz AM. Contraception in Women Over 40 Years of Age. CMAJ 2013; 185(7):565-73.

ACOG Practice Bulletin No 206: Use of Hormonal Contraception in Women with Co-Existing Medical Conditions. Obstet Gynecol 2019; 133(2):e128.

Hoffman BL, Schorge JO, Schaffer JI, Halvorson LM, Bradshaw KD, Cunningham FG. (2012). Williams Gynecology. McGraw-Hill Companies, Inc.

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