Menopause is when your periods stop completely. Perimenopause is the term for the period "around the time of menopause." The perimenopausal years are the 3 to 5 years before your final period. The timing of actual menopause is different for each woman. Although some women stop having periods in their 30s, the average age is the early 50s. So, perimenopausal women are usually in their 40s or early 50s.
Very-low-dose birth control pills (brand names: LoEstrin 1/20, Alesse) have less estrogen than regular birth control pills. These pills typically have 20 micrograms of estrogen, compared with 30 to 50 micrograms of estrogen in regular birth control pills.
If you're still having periods, very-low-dose birth control pills prevent pregnancy and may also have some health benefits. They can reduce hot flashes and vaginal dryness (which are symptoms of perimenopause and menopause). Very-low-dose birth control pills can also help regulate your periods if they are heavy or irregular. They may also prevent bone loss (which occurs during menopause), and helps protect you from osteoporosis. Another potential benefit is protection from cancer of the ovary and uterus. The lower dose of estrogen in these pills (compared to regular birth control pills) is believed to be safer for women who are perimenopausal.
Perimenopausal women who have a history of deep blood clots, breast cancer or heart disease should not take very-low-dose birth control pills. Perimenopausal women who smoke also should not take them.
Very-low-dose birth control pills are taken the same way as other birth control pills, which is orally. They are usually started on the first Sunday after your period starts. If you're perimenopausal but you aren't having regular periods, you can probably take a hormone called medroxyprogesterone acetate (one brand name: Provera) to start your period. (Your doctor will check you for pregnancy first.)
These pills are taken for 21 days in a row and then not taken for 7 days. During the 7 days without medicine, your period will start. Seven days later, you will start taking the very-low-dose birth control pills for another cycle.
The hormone doses in these pills are so low that most women do not experience side effects. You might have breast tenderness, nausea, higher blood pressure or headaches. It's also possible that these very-low-dose birth control pills may not regulate your periods. If you're having any abnormal bleeding, it might get worse. There is also evidence that estrogen slightly increases your risk of breast cancer, so you should talk with your doctor if you have questions or concerns.
You and your doctor will decide together how long you should take this medicine. You can stop taking very-low-dose birth control pills any time. The decision to change from the low-dose birth control pills to estrogen replacement therapy or another type of treatment for menopause is usually made around the age of 49 to 52. Your doctor can also measure a hormone called FSH (follicle-stimulating hormone) to see if you're in menopause.
Talk to your doctor to see if very-low-dose birth control pills might be a good idea for you during your perimenopausal years.