Exploring Birth Control Choices in Menopause: Sabrina Johnson’s Exclusive Insights

You’ll not be as fertile in your 30s as in your early and late 20s. When you’ve reached 35, your fertility starts declining even more, and by 45, it’s at its lowest. But that doesn’t mean you cannot get pregnant, not until you’ve hit menopause – i.e., a year without a period.

So, it must have crossed your mind if you still need to opt for birth control measures when your pregnancy chances are almost nil. The rhythm or natural family planning method won’t work in perimenopause due to irregular menses. Deciding what to do is important, especially for family caregivers, as you don’t want one more unpredictable factor in the mix.

To give you a brief insight into the role of birth control pills in menopause, we have Sabrina Johnson with us to help you out with the countless doubts going on in your mind regarding the same.

A medical writer with a gynecological background, Mrs. Johnson clearly understands the challenges women face in menopause. A month back, we interviewed her on how effective birth control choices are in menopause after shortlisting questions we received from several women across the United States. Here are the excerpts from the Q&A session we had with Mrs. Johnson.

Q1. Will birth control pills affect the symptoms of menopause?

A. Birth control pills won’t affect menopause but will mask the symptoms. When you are transitioning into menopause, the estrogen-progesterone levels decline. Birth control pills could either be a mix of estrogen and progestin, also called combination pills. In contrast, some are progestin-only pills devoid of estrogen.

So, when you take these pills in your late 40s or early 50s, they make up for the hormones you are losing naturally and don’t allow your body to identify the low estrogen and progesterone levels.

Thus, menopause may have started, but it isn’t evident because you aren’t undergoing the symptoms you should due to hormonal imbalances.

If you are on progestin-only pills, you’ll still experience hot flashes and irregular menses.

But, if on the combination pill, most of the symptoms, like night sweats and hot flashes, will be concealed. You may even bleed like you did when your menses were on. So, it’s hard to say if you are transitioning or have hit the menopause phase already.

To confirm if the perimenopause phase has begun, you would need to pause the pills for a while, not without consulting the doctor, though.

Q2. How will I know that menopause has started when I am on pills?

A. A friend in her 50s wondered why menopause took so long when everyone in her age group had hit that stage. She wasn’t panicking but was anxious. The doctor advised her to go off pills for a while, which she was taking to avoid accidental pregnancies.

The moment she stopped the pills, her menses paused and didn’t come back. Many doctors suggest being off the pills for a while when you’ve reached 50-51, as that’s the average menopausal age.

However, it isn’t safe to stop pills during sex until menopause is confirmed. If you don’t want to be on pills after your 50s, you can go for barrier methods like sponges or condoms to prevent the sperm from reaching the egg.

Q3. Which birth control choices are the most effective in menopause?

A. Before answering this question, I would like to talk about the kinds of birth control measures available.

• Hormonal contraceptives come in a combination of estrogen-progestin or progestin-only pills. They are available as pills and even as vaginal rings, skin patches, and shots.

• IUDs or intrauterine devices are placed in the uterus through your vagina. It’s T-shaped and varies from hormonal to non-hormonal devices. The hormonal ones contain progestin, while the non-hormonal ones are copper-coated.

• Barrier methods include condoms, spermicide, diaphragms (with spermicide), cervical caps, and spermicide sponges.

Coming to the question, when in menopause, which birth control methods should you opt for? Your doctor will be the best person to find the suitable option for you based on your overall health.

However, the progestin-only pills or mini-pills will still show symptoms like irregular bleeding and hot flashes in the early menopause transition phase. Breastfeeding women and those at risk of strokes or blood clots mostly opt for the mini-pills.

There are nonhormonal options as well, like the barrier methods. However, they aren’t as effective in preventing pregnancies as the hormonal options. So, before you make a decision, consult your healthcare provider, who will help you decide on the birth control options that would suit you the best in your 40s and 50s.

Q4. What are the benefits and side effects of hormonal birth control pills around menopause?

A. The hormonal birth control pills, mainly the combination ones, do conceal most of the menopausal symptoms, but they come with several benefits, too. Let’s take a look at them;

Benefits of hormonal birth control pills

Here are some of the benefits of the birth control pills:

• Strengthens your bones

• Minimizes hot flashes

• Regularizes your menses and lessens pain and bleeding during periods

• Minimizes the occurrences of acne and other skin issues (particularly the combination pills)

• Reduces risks of uterine and ovarian (by around 30-50% using oral contraceptives over those who didn’t)

Side effects of hormonal birth control pills

Where there are benefits, risks aren’t behind. For those aged 35 and above, birth control pills can increase the risks of breast cancer, strokes, blood clots, and heart attacks.

Moreover, those diagnosed with the following conditions should refrain from hormonal birth control methods. These include:

• Cancer
• Cardiovascular disease
• Cancer
• High blood pressure
• Diabetes
• Clotting disorders

Q5. Why are hormonal pills risky for smokers?

A. If you’ve been a smoker most of your life, then you must think twice before opting for birth control pills, particularly the combination ones.

Smoking often restricts blood vessels, while birth control pills thicken blood flow, increasing the risk of heart ailments. So talk to your doctor, who may perhaps suggest alternatives.

Many healthcare providers recommend progestin-only pills for those with a history of smoking. It comes with lesser risk.

Q6. When should you stop taking hormonal pills for birth control?

A. There isn’t any definitive answer as it varies from person to person. Healthcare providers often suggest refraining from using hormonal birth control measures after 50. There are lower chances of pregnancy.

However, until your menses have stopped, use some form of birth control measures during sex, even if it isn’t the hormonal ones. Your doctor may help you better.

Q7. Is the barrier method safer than the hormonal pills?

A. Every birth control method has its set of risks. The barrier method isn’t an exception. It doesn’t impact your hormones and won’t hide your menopausal symptoms.

But it has its set of side effects. It could trigger an allergic reaction, vaginal burning, or UTI. It may even result in toxic shock syndrome. Before you panic, I want to let you know it’s rare.

Conclusion

I hope these valuable insights of Mrs. Johnson will be of help when you ponder about the boons and banes of birth control choices. When you’ve reached your 50s, you should think twice before randomly opting for hormonal pills, particularly the ones with estrogen.

Talk to your doctor and discuss the best option that won’t take a toll on your health. You should even let the medical expert know of any pre-existing health issues so that he can help you make the best choice.