The Birth Control Pill is Safe for Bones in Perimenopause

The business of hating the pill comes to menopause

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There can be a wide range of bothersome symptoms during the menopause transition, also known as perimenopause, and one of the big ones is irregular and/or heavy bleeding. Some people also suffer from a worsening of premenstrual syndrome (PMS) and menstrual migraines, and of course hot flashes can start before the final period (which is what officially marks menopause).

To manage these symptoms, many turn to hormonal contraception, specifically the estrogen-containing oral contraceptive pill. It’s a great option here. It’s fantastic for controlling bleeding, is evidence-based therapy for PMS, and can also help menstrual migraines when taken continuously so there is no menstruation. In addition, the estrogen dose is higher than what is found in menopausal hormone therapy, so it’s excellent for hot flashes and other symptoms. And of course, it provides contraception for those who need it.

The specific advantage of the pill here over menopausal hormone therapy is that the dose and type of hormones suppresses ovulation, keeping the follicles suspended at day 3 of the cycle. This provides superior control of bleeding and a steady level of hormones as opposed to the chaos of the menopause transition. For many people it’s the fluctuations in hormones in  menopause or the hormonal chaos that causes symptoms, not the actual levels of hormones. The pill controls the chaos.