Birth control pills hot flashes: Symptoms of Menopause While on Birth Control Pills: What to Expect

16.09.202325.06.2023 by alexxlab

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Symptoms of Menopause While on Birth Control Pills: What to Expect

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Medically reviewed by Debra Rose Wilson, Ph. D., MSN, R.N., IBCLC, AHN-BC, CHT — By Kathryn Watson on November 21, 2017

Will you experience traditional menopause symptoms?

As you age, your body gradually slows its production of estrogen. Your periods will also become irregular. When this happens, it’s known as perimenopause.

After you’ve gone a full year without having a menstrual period, you’ve reached menopause. Symptoms like hot flashes and sleep disturbances are common during this time.

But if you’re taking birth control pills, you might not associate these symptoms with menopause. Hormonal birth control — such as the pill — often causes symptoms like these.

Keep reading to learn why this is, symptoms you should watch for, and more.

How birth control masks menopause symptoms

Birth control pills are a form of hormonal contraception. Combination pills contain synthetic forms of estrogen and progesterone, two naturally occurring hormones. Minipills contain only progestin, which is the synthetic version of progesterone.

In addition to preventing pregnancy, birth control pills help regulate your body’s hormone levels. As you approach menopause, your body’s natural estrogen levels will start to decrease — but the pill’s synthetic hormones prevent your body from recognizing this decline.

You’ll also continue to experience a monthly bleed, though this will depend on the type of pill you’re taking. For example, women who take combination birth control pills will continue to have a week of period-type bleeding each month. Women who take the minipill may experience more irregular bleeding.

Birth control pills also have side effects that are similar to menopause symptoms. These include:

spotting between periods
hot flashes
mood swings
changes in appetite

How to determine whether you’ve reached menopause

The average American woman will reach menopause around age 51, but perimenopause can begin in your early 40s or even earlier. You may suspect that your body is changing due to decreased breast fullness or a slowed metabolism, but your doctor won’t be able to tell you for sure.

There’s no test to determine if you’re menopausal, so watching for changes in your body is essential.

There are some benefits to taking birth control pills during perimenopause, so speak to your doctor about when and how to stop taking your pills. You may need to switch to a different form of hormonal contraception or use barrier methods, like condoms, to continue to prevent pregnancy.

If you do decide to stop taking the pill, it can take anywhere from four weeks to several months for your body’s natural hormones to take over.

During this time, you’ll need to communicate with your doctor about what to expect in terms of side effects. If it turns out you’ve already reached menopause, your period might not come back at all.

What to expect if you’ve reached menopause

As you approach menopause, your periods will become sporadic. Your period may skip a month or two before returning, and you may have breakthrough spotting in between. Once you’ve gone a whole year without getting your period, you’ve reached menopause.

In addition to period irregularity, you may experience:

fatigue
night sweats
hot flashes
insomnia
mood swings
change in libido
vaginal dryness

Having less estrogen also increases your risk for certain health conditions, such as obesity, heart disease, and osteoporosis. You should talk to your doctor about these conditions as well as any family history of high blood pressure or cancer.

Keeping up with your regular health screenings can help reduce your risk for further complications, as well as help with symptom management.

If your menopause-related symptoms are severe, your doctor might suggest targeted treatments to help improve your quality of life.

What treatment options are available

What the outlook is

The average woman experiences perimenopause symptoms for around four years before menstruation stops completely. Keep in mind that this time frame can vary, so this period may be shorter or longer for you.

If you think you’re approaching menopause, talk to your doctor. They can help determine whether you should continue taking your pill, switch to a different hormonal therapy, or stop using contraception all together.

Treatment options are available, so don’t hesitate to tell your doctor how you’re feeling.

Remember that this phase is only temporary, and that your symptoms will subside completely once your body adjusts to your new hormone levels.

Last medically reviewed on November 21, 2017

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How we reviewed this article:

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10.1055/s-2005-869479
Estrogen and progestin: Oral contraceptives. (2015).
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How do I know I’ve reached menopause if I’m on the pill? (2017).
nhs.uk/Conditions/contraception-guide/Pages/menopause-contraceptive-pill.aspx
Inayat K, et al. (2017). Symptoms of menopause in peri and postmenopausal women and their attitudes towards them [Abstract].
ncbi.nlm.nih.gov/pubmed/29076687
Mayo Clinic Staff. (2017). Menopause: Diagnosis and treatment.
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Menopause, perimenopause, and postmenopause. (2017).
my.clevelandclinic.org/health/articles/what-is-perimenopause-menopause-postmenopause

Our experts continually monitor the health and wellness space, and we update our articles when new information becomes available.

Current Version

Nov 21, 2017

Written By

Kathryn Watson

Edited By

Nizam Khan (TechSpace)

Medically Reviewed By

Debra Rose Wilson, PhD, MSN, RN, IBCLC, AHN-BC, CHT

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Medically reviewed by Debra Rose Wilson, Ph. D., MSN, R.N., IBCLC, AHN-BC, CHT — By Kathryn Watson on November 21, 2017

What are the symptoms of menopause while on birth control pills?

Many people use hormonal birth control, including those in perimenopause. However, birth control can mask some menopause symptoms, making it difficult to tell if a person has reached it.

People do not reach menopause itself until a year after their last menstruation.

They may get the typical symptoms of menopause at this time, including hot flashes, irregular periods, and sleep problems. However, hormonal contraceptives can mask these symptoms or cause side effects that people may confuse with natural hormone fluctuations.

Read on for the answers to some common questions about how birth control pills can affect the symptoms of menopause.

Menopause occurs due to a decline in the levels of estrogen and progesterone, which are the two hormones responsible for a person’s menstrual cycle. These hormones also help to support a developing pregnancy.

Birth control pills contain synthetic forms of one or both of these two hormones. Combination pills contain both types of hormones. Taking these hormones can prevent the body from recognizing the natural decline in estrogen and progesterone that occurs during menopause.

As a result, the symptoms that a person typically experiences during perimenopause may not be as apparent or noticeable if they are taking birth control pills. One such symptom is an irregular period, which is very common during this stage.

However, a person who is taking the minipill, which contains only a synthetic form of progesterone, may be more likely to experience irregular bleeding and hot flashes during early menopause.

The hormones in combination birth control pills will help to regulate the menstrual cycle and hormones, which will prevent many of the symptoms of menopause.

However, it is possible that the pill will cause side effects that are very similar to the symptoms of hormone fluctuation. These can include:

mood swings
decreased libido
changes in appetite

People may also experience irregular periods or spotting between cycles, especially if they are taking the minipill.

It can be hard to tell if some symptoms are side effects of the synthetic hormones or are due to natural hormone fluctuations in the body.

One way to check is to stop taking the birth control pill to allow the body’s natural cycle to resume. It can take some time for the natural hormones to kick back in and for regular menstrual cycles to begin again.

If symptoms continue when someone stops taking the birth control pill, including irregular bleeding, it is likely that they are going through perimenopause. Conversely, if the symptoms go away, these were probably side effects of the pill.

When coming off the pill, it is essential to wait at least a few months to give the hormones time to readjust.

It is important to recognize the possibility that the birth control pill was masking perimenopause or menopause. If this is the case, menstruation will no longer occur if a person stops taking the pill.

If a person is on birth control, there is no way to know for sure. Someone who is taking the pill may still have regular periods because of the hormones in the medication.

The average age of a person reaching menopause is around 51 years old. Some doctors may recommend that a person stops taking the pill around this age to see if they have reached menopause yet.

However, people stopping the pill at this age should still use contraception during sex until they have confirmation of menopause.

Menopause occurs when a person no longer has menstrual periods. The time leading up to menopause is known as perimenopause. This can begin up to 15 years before menopause.

The signs that a person is approaching menopause include:

fatigue
night sweats
insomnia
hot flashes
mood swings
anxiety or depression
changes in sex drive
vaginal dryness
thinning skin

Going through menopause can increase the risk of certain diseases, such as heart disease, osteoporosis, and certain cancers. Therefore, it is imperative to stay in touch with a doctor both during and after menopause.

Each person’s experience of menopause is different. Menopause symptoms will affect and bother some people more than others.

One of the main treatments for menopause symptoms is hormone replacement therapy (HRT). This involves taking forms of estrogen and progesterone to mimic the natural menstrual cycle.

HRT can help reduce or prevent the symptoms relating to declining estrogen levels. HRT does not provide contraception, so if a person needs contraception and desires relief from perimenopause symptoms, birth control pills can be ideal for treatment.

However, medication is not always necessary to manage symptoms. Some people find relief from home remedies, which include:

reducing caffeine intake
using ice packs to manage hot flashes
exercising regularly
taking herbal supplements, such as black cohosh, red clover, dong quai, ginseng, kava, and evening primrose oil
wearing several layers of clothing that are easy to remove
using a vaginal lubricant during sex
maintaining an active social life
finding outlets for stress
limiting alcohol intake

Menopause is a natural process that all females will go through at some point in their life. However, taking the birth control pill can mask some of the symptoms of menopause, making it difficult for a person to tell if they have reached it.

For many people, it is safe to stay on the birth control pill while transitioning through perimenopause, especially if they do not have a history of:

estrogen-dependent cancer
high blood pressure
heart disease
diabetes
blood clots

Staying on birth control during perimenopause is also essential if contraception is necessary.

Generally, it is best for someone who thinks they may be going through menopause to speak with their doctor. The doctor can advise on a person’s specific situation and what may be best for them.

What contraceptive measures to take after 40 years

Vigilance must not be lost: after 40 there is a risk of becoming pregnant, and this pregnancy can be a test for both mother and child. Women over 40 need effective contraception if they want to avoid pregnancy.

What changes with age?

The risk of pregnancy in women over 40 is relatively low. For example, in 2008, for every 1,000 Canadian women aged 40-44, there were 8-9births. ^[1]

On the other hand, the risk of spontaneous abortion and fetal chromosomal abnormalities increases significantly after 40 years of age. In addition, pregnancy often occurs with complications (high blood pressure, diabetes in pregnant women, etc.). ^[2]

Why do you need contraception after 40 years?

You must not lose your vigilance: after 40 there is a risk of becoming pregnant, and this pregnancy can be a test for both the mother and the child. Women over 40 need effective contraception if they want to avoid pregnancy. ^[1]

In addition, women of this age may experience extremely distressing perimenopausal symptoms (eg, hot flashes, sweating, heart palpitations). In this case, taking hormone replacement therapy or hormonal drugs can be a real relief from their pain. ^[1]

What contraceptive methods are used after 40 years of age?

When it comes to regular contraception, WHO puts 9 first in its recommendations0027 intrauterine devices (copper and progestin), progestin implants (these are subcutaneous implants with a hormone, for example, levonorgestrel) and sterilization (and how both female and male). During the first year of using any of these methods, unwanted pregnancy occurred extremely rarely – in only 1% of cases. ^[3]

In countries such as the US and Canada, non-hormonal contraceptives lead by a wide margin (in the US, half of women over 40 prefer sterilization as the safest option, and half of Canadians prefer condoms) . However, one in 10 women in the US and the UK and one in five Canadians take a variety of combined oral contraceptives (COCs). ^[3]

If a woman over 40 has not chosen a planned method of contraception, she can use any method of emergency contraception – there is no age limit for them. But if emergency methods are the same at any age, then the rules for prescribing planned contraception change slightly. ^[3]

COC “Bonuses”

ensure regular menstruation ^[9] ,
reduce blood loss, reduce the severity of anemia caused by heavy uterine bleeding
significantly reduce hot flashes, sweating and other unpleasant symptoms of perimenopause ^[4] .

Sometimes contraceptives are prescribed in perimenopause precisely to eliminate unpleasant symptoms. In this case, it is important to remember that hormone therapy prescribed for this purpose may not provide the proper contraceptive effect if the regimen is not followed or, for example, when smoking. ^[11]

What are the risks of taking birth control pills after 40?

Will taking contraceptives create additional risks for a woman? Will the condition of the heart and blood vessels worsen? What about cancer risk? Let’s go in order.

Yes, there are conditions in which doctors are very, very careful when prescribing contraceptives.

About the heart. Before prescribing contraceptives, doctors carefully weigh all the risks, paying special attention to the cardiovascular system. ^[10]

The use of drugs containing estrogen increases the risk of thrombosis, but only in women with additional cardiovascular risk factors.
With caution, the doctor prescribes contraceptives to women with chronic diseases – obesity, diabetes, high blood pressure.4 Women with risk factors for thrombosis are observed more comprehensively – with the involvement of both a gynecologist and a cardiologist. To conditions with unacceptable risk (that is, with them COCs unambiguously cannot be accepted ) refer to:

Uncontrolled hypertension – blood pressure above 160/100 mm Hg ^[10]
Stroke or heart attack in the past. ^[10]
Smoking, deep vein thrombosis more than 15 cigarettes per day ^[10]

Pro cancer . Of particular concern to women and their physicians is the relationship between hormonal contraceptives and breast cancer 0029 .

There was no significant association between the use of oral contraceptives and the risk of developing breast cancer. ^[6]
With regard to the risk of endometrial cancer , oral contraceptives prevent excessive growth of the endometrium and significantly reduce the risk of this type of cancer. ^[7]

When can I stop using protection?

Women over 40 who no longer want children should use effective contraception until 2 years have passed since their last menstrual period. ^[1]

^{^[1]} Allen RH, Cwiak CA, Kaunitz AM. Contraception in women over 40 years of age. C Can Med Assoc J . 2013;185(7):565-573. doi:10.1503/cmaj.121280.

^[2] Cleary-Goldman J, Malone F.D., Vidaver J, et al. Impact of maternal age on obstetric outcome. Obstet Gynecol . 2005;105(5 Pt 1):983-990. doi:10.1097/01.AOG.0000158118.75532.51.

^[3] Johns Hopkins Bloomberg School of Public Health/Center for Communication Programs and World Health Organization. Family Planning: A Global Handbook for Providers . Geneva (Switzerland): World Health Organization; 2011.

^[4] Kaunitz AM. clinical practice. Hormonal contraception in women of older reproductive age. N Engl J Med . 2008;358(12):1262-1270. doi:10.1056/NEJMcp0708481.

^[5] Cardiovascular disease and use of oral and injectable progestogen-only contraceptives and combined injectable contraceptives. Results of an international, multicenter, case-control study. World Health Organization Collaborative Study of Cardiovascular Disease and Steroid Hormone Contraception. Contraception . 1998;57(5):315-324.

^[6] Marchbanks PA, McDonald JA, Wilson HG, et al. Oral contraceptives and the risk of breast cancer. N Engl J Med . 2002;346(26):2025-2032. doi:10.1056/NEJMoa013202.

^[7] Weiderpass E, Adami HO, Baron JA, Magnusson C, Lindgren A, Persson I. Use of oral contraceptives and endometrial cancer risk (Sweden). Cancer Causes Control . 1999;10(4):277-284.

^[8] Isley MM, Kaunitz AM. Update on hormonal contraception and bone density. Rev Endocr Metab Disord . 2011;12(2):93-106. doi:10.1007/s11154-011-9180-6.

^[9] Davis A, Godwin A, Lippman J, Olson W, Kafrissen M. Triphasic norgestimate-ethinyl estradiol for treating dysfunctional uterine bleeding. Obstet Gynecol . 2000;96(6):913-920.

^[10] U S. Medical Eligibility Criteria for Contraceptive Use, 2010. MMWR Recomm reports Morb Mortal Wkly report Recomm reports . 2010;59(RR-4):1-86.

^[11] ^{Gebbie AE, Glasier A, Sweeting V. Incidence of ovulation in perimenopausal women before and during hormone replacement therapy.} ^{Contraception . 1995;52(4):221-222.}

History of contraception

Ancient times
One of the first mentions of a condom as a means of protection in antiquity is around 3000 BC. In Crete…

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Intrauterine device

The intrauterine device is a small plastic device that is inserted inside the cervix and provides contraceptive…

Menopause is not a disease

The period of menopause is a natural and logical stage in the life of every woman. At this time, the function of the ovaries gradually fades away, in which the female sex cells mature, the production of female sex hormones is reduced, the ability to conceive is lost, the body goes into a state of old age. An important role in overcoming this stage is played by awareness of menopause, methods of treating menopausal symptoms, and ways to eliminate them. The sooner you arm yourself with this knowledge, the easier it will be to overcome it.

Stages of menopause and its symptoms

Formally, the period of menopause
can be divided into three stages – premenopause, menopause and postmenopause.

1. Premenopause is characterized by the first signs of the extinction of the reproductive function: menstrual irregularities, changes in the nature of menstruation (less abundant, shorter or, on the contrary, longer, more abundant), hot flashes, sweating, anxiety, chills, headaches, blood pressure disorders.

2. Menopause is assessed after a while – it is possible to talk about its onset only after 12 months from the day of the last menstruation. At this stage, problems with urination, impaired memory and concentration may appear.

3. After menopause, a woman enters the postmenopausal period. In postmenopause, the functioning of the ovaries finally ends, the bone apparatus becomes fragile, there is a risk of atherosclerosis, skin and hair become dry.

The main symptoms of menopause:

● Hot flashes, excessive sweating, chills;

● Depression, anxiety, irritability;

● Sleep disorders;

● Dryness, burning, discomfort in the vagina;

● Headaches;

● Rapid heartbeat, changes in blood pressure;

● Disorders of urination, incontinence;

In a later period, menopause can cause changes such as loss of bone density (osteoporosis), the development of atherosclerosis and related diseases (ischemic heart disease, heart attack, stroke).

Choice of therapy, indications and contraindications

In addition to general recommendations about proper nutrition, sleep patterns, physical activity and the rejection of bad habits, there are other methods for correcting menopause symptoms. To solve the problem of lack of female hormones, you can by taking hormonal drugs. This treatment is called hormone replacement therapy.
and can only be prescribed by a gynecologist.

What is the effect of hormone replacement therapy, why is it needed? For many years, all organs and systems of a woman’s body have been exposed to sex hormones and interacted with them. With a reduction in the production of female sex hormones, the entire body suffers: organs and systems are forced to rebuild taking into account the new hormonal status. This process usually does not go easily and smoothly. In conditions of a decrease in the amount of hormones, there is a risk of cardiovascular diseases, loss of bone density. Hormone therapy allows you to maintain the body in its usual state, avoid sudden changes, protect it, increase life expectancy and smooth out the course of menopause. Taking hormonal drugs in the postmenopausal period is very effective and, with timely and competent appointment, can reduce the risk of myocardial infarction and stroke by more than 2 times. ³

The choice of the drug is carried out by the gynecologist after examination and obtaining the result of the tests. In each individual case, the drug and its regimen must be justified by a specialist. The general requirements for hormone therapy are efficacy, safety and acceptability for a particular patient.

Indications for prescribing hormone therapy:

● Symptoms of menopause;

● Prevention of postmenopausal osteoporosis
(increase in the “porosity” of bones, a decrease in their strength and density, leading to fractures)

Before prescribing the drug, the doctor must conduct a series of studies to identify all the features and needs of your body. As a rule, the list of such studies, in addition to the examination, includes an ultrasound of the pelvic organs, a study of the mammary glands, blood biochemistry and a cervical smear.

Contraindications to the use of hormonal drugs:

● Breast cancer
and genital organs, as well as any hormone-dependent oncological diseases;

● Bleeding of unclear origin;

● Cases of blockage of blood vessels by blood clots in the past;

● Liver and kidney failure.

As we can see, these are serious conditions that limit the use of not only hormone replacement therapy, but also a huge number of other drugs. Not every woman who has entered the menopause is faced with them. There are also borderline situations with relative contraindications. The presence of relative contraindications suggests that in each case, the risk-benefit ratio of therapy should be considered. To make the right decision, you need to conduct a thorough examination and consult with a competent doctor. Despite the large number of herbal preparations and dietary supplements for the treatment of menopause symptoms, their effectiveness is significantly inferior to hormone replacement therapy drugs. None of them prevent the development of osteoporosis, metabolic disorders or changes in body weight. ⁴

Unfortunately, the use of hormone replacement therapy in Russia to correct the symptoms of menopause is extremely small. Due to lack of information and prejudice against hormone therapy, patients choose ineffective treatment or refuse it altogether. Very often, the fear of side effects is caused by ignorance that all of them are associated not with the use of female hormones, which are part of most hormone replacement therapy drugs, but with the use of old drugs of the contraceptive group. In case of doubts about hormone replacement therapy, do not make a hasty and categorical decision before talking with a specialist. Timely (that is, during menopause and early postmenopause) the use of hormone replacement therapy according to indications has a positive effect on the life and health of a woman.

Preparations for menopause

Preparations for menopause can be both hormonal and non-hormonal in composition. The choice of the type of therapy is carried out after consultation with a specialist and identifying possible pros and cons, indications and contraindications for a particular type of treatment.

Non-hormonal drugs for menopause solve the problem of symptoms and can complement hormone therapy. These include sedatives to eliminate irritability, antibacterial – in the presence of an infection, increasing immunity according to indications, etc. ⁵

Hormonal drugs for menopause are prescribed by a doctor according to indications. Hormone therapy is of two types: including only the female hormone estrogen or consisting of preparations with estrogens and another hormone, progesterone. Reception regimens may also vary depending on the period of menopause – premenopause or postmenopause: some patients are prescribed drugs cyclically, others – continuously. ³

There are many ways to take hormones: oral (pills), transdermal (patches and gels), vaginal (creams, rings, tablets), intrauterine (spirals), injection and subcutaneous (injections and implants).

To date, there are effective hormone therapy drugs, and their list continues to grow. The composition of modern hormone therapy preparations includes substances that do not have a strong effect on the liver and carbohydrate metabolism, but effectively perform their tasks. All drugs used in our country can be divided into monophasic and biphasic. A monophasic preparation consists of doses of one composition for the entire course of treatment. Taking a biphasic drug involves taking two types of pills in sequence. ⁴

Herbal preparations contain phytoestrogens (herbal preparations contain phytoestrogens – analogues of female hormones of plant origin). It is believed that these substances have a similar structure to female sex hormones. Their effectiveness is limited, they do not affect the prevention of serious consequences of menopause and are symptomatic therapy for hot flashes. They can be used in cases where hormonal therapy is excluded due to the presence of serious contraindications. Fortunately, this is not common, so in most cases, doctors recommend modern hormone-based drugs. ⁵

Of course, it is impossible to avoid old age with the help of hormonal and non-hormonal therapy drugs, but it is definitely worth using their opportunities to maintain health and a high quality of life. Hormone therapy is a really effective way to deal with the symptoms of menopause. It avoids the development of dangerous diseases, reduces the risk of myocardial infarction, hip fracture, and prolongs life. It must be remembered that the decision to prescribe hormone replacement therapy should only be made by a doctor. ⁶ It is important to choose a competent specialist who will prescribe an appropriate examination and individually select the drug, its regimen and dose. You can find a list of professional doctors here.

Serov VN Menopausal period: normal state or pathology //Rus. honey. magazine – 2002. – T. 10. – No. 18. – S. 791.
Smetnik VP Systemic changes in menopausal women //Russian Medical Journal. – 2001. – T. 9. – No. 9. – S. 358-361.
Doskina EV Treatment of pathological climacteric in women // Attending physician. – 2005. – no. 5. – S. 5.
Tikhomirov A. L., Oleinik Ch. G. Newspaper “Medicine and Pharmacy News” Obstetrics, Gynecology, Reproductology (317) 2010 (thematic issue). pp. 6-8
Balan V.